Abstract
Teramoto distal tibial oblique osteotomy (DTOO) is a joint-preserving surgery for ankle osteoarthritis (AOA). However, there are few articles on the radiological assessment of DTOO. The purpose of this study was to report the clinical outcomes and radiological evaluations of weight-bearing radiographs before and after DTOO.We retrospectively reviewed 52 patients who underwent DTOO between 2007 and 2018. We recorded the Tanaka–Takakura classification, fixation methods, Japanese Society for Surgery of the Foot Ankle/Hindfoot Scale (JSSF scale), and complications. The tibial articular surface angle (TAS), medial malleolar angle (MMA), tibial lateral surface angle (TLS), talar tilt angle (TTA), and tibiotalar surface angle (TTS) were evaluated using weight-bearing ankle radiographs.The median patient age was 66 years, and the mean follow-up duration was 46 ± 23 months. Two stage 2, 9 stage 3a, 30 stage 3b, and 11 stage 4 according to the Tanaka–Takakura classification were performed using DTOO. The JSSF scale improved significantly from 39.9 ± 13.8 before surgery to 87.2 ± 7.5 after surgery. Seven cases were fixed using a locking plate, and 45 cases were fixed using a circular external fixator. The TAS, MMA, TLS, TTA, and TTS significantly changed before and after DTOO.Radiological evaluation indicated that DTOO influences talar behavior during weight-bearing, and improves the clinical outcomes of AOA.
Highlights
Degenerative ankle osteoarthritis (AOA) is relatively rare compared with that in the hip and knee
Ankle arthrodesis (AA) or total ankle replacements (TAR) are indicated for these patients, but orthopedic surgeons tend to hesitate to perform ankle arthrodesis (AA) due to the residual range of ankle motion or adjacent arthritis[2,3] and are concerned with the relatively poor prognosis of TAR compared with total hip replacement or total knee replacement.[4]
We and our colleagues have performed distal tibial oblique osteotomy (DTOO) for progressive or end-stage AOA. This procedure is completely different from low tibial osteotomy (LTO) at the point of obtaining joint congruity and stability
Summary
Degenerative ankle osteoarthritis (AOA) is relatively rare compared with that in the hip and knee. Teramoto devised distal tibial oblique osteotomy (DTOO) as an ankle joint-preserving surgery for AOA in 19945 and first reported this procedure in English in 1996,6 and subsequently studies have been published since.[5,7,8] We and our colleagues have performed DTOO for progressive or end-stage AOA. This procedure is completely different from low tibial osteotomy (LTO) at the point of obtaining joint congruity and stability. The purpose of this study was to report the concepts, operative techniques, clinical outcomes, and radiological evaluations of DTOO
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call