Journal article
Sagittal Distal Tibial Articular Angle and the Relationship to Talar Subluxation in Total Ankle Arthroplasty
Foot & ankle international, Vol.37(9), pp.929-937
09/2016
DOI: 10.1177/1071100716660523
PMID: 27480501
Abstract
Longevity of total ankle replacement (TAR) depends heavily on anatomic alignment. The lateral talar station (LTS) classifies the sagittal position of the talus relative to the tibia. We hypothesized that correcting the sagittal distal tibial articular angle (sDTAA) during TAR would anatomically realign the tibiotalar joint and potentially reduce the risk of prosthesis subluxation.
The LTS (millimeters) and sDTAA (degrees) were measured twice by 2 blinded observers using weight-bearing lateral ankle radiographs obtained before (n = 96) and after (n = 94) TAR, with excellent interobserver and intraobserver reliability (correlation coefficient >0.9).
Preoperative LTS was as follows: anterior (60.4%), posterior (27.1%), and neutral (12.5%). A strong preoperative correlation was found between LTS and sDTAA (r = 0.81; P < .0001). In ankles that were initially anterior and became less anterior postoperatively (n = 41), LTS decreased from an average 8.1 mm to 6.5 mm and the LTS changed 1.1 mm per degree of sDTAA change. In ankles that were initially posterior (n = 25), LTS increased from an average of -5.1 mm to -2.8 mm and the LTS changed 0.6 mm per degree of sDTAA change. The correlation between LTS and sDTAA was reduced postoperatively (r = 0.62; P < .0001).
Our results suggest that rather than following generic recommendations, the surgeon should customize the sagittal distal tibial cut to the individual patient based on the preoperative LTS in order to achieve neutral TAR alignment.
Level III, retrospective comparative series.
Details
- Title: Subtitle
- Sagittal Distal Tibial Articular Angle and the Relationship to Talar Subluxation in Total Ankle Arthroplasty
- Creators
- Andrea Veljkovic - Division of Distal Extremities, Department of Orthopaedics, University of British Columbia, Victoria, BC, Canada docveljkovic@yahoo.comAdam Norton - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USAPeter Salat - Joint Department of Medical Imaging, University of Toronto, Toronto, ON, CanadaKaniza Zahra Abbas - University Health Network-Toronto Western Division, Toronto, ON, CanadaCharles Saltzman - Department of Orthopedics, University of Utah, Salt Lake City, UT, USAJohn E Femino - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USAPhinit Phisitkul - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USAAnnunziato Amendola - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Foot & ankle international, Vol.37(9), pp.929-937
- Publisher
- United States
- DOI
- 10.1177/1071100716660523
- PMID
- 27480501
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Language
- English
- Date published
- 09/2016
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040269302771
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