Document Detail

Intra-articular opening medial tibial wedge osteotomy (plafond-plasty) for the treatment of intra-articular varus ankle arthritis and instability.
MedLine Citation:
PMID:  22735196     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although supramalleolar osteotomy with an opening medial wedge or a closing lateral wedge have been described for varus ankle deformity, these may be associated with failure due to persistence of the medial intra-articular defect, resulting in recurrent varus deformity. We report the results of a retrospective study assessing the outcome of an intra-articular opening wedge osteotomy of the distal medial tibia (plafond-plasty) for intra-articular varus ankle deformity associated with osteoarthritis and ankle instability.
METHOD: The results of 19 plafond-plasties in 19 patients for correction of intra-articular varus osteoarthritis of the ankle associated with ankle instability were reviewed. Fourteen men and five women of a mean age of 47 (range, 32 to 63) years were treated. Followup ranged from 14 to 98 (mean, 59) months.
RESULTS: Lateral ligament reconstruction was done at the time of the surgery in 18 out of 19 patients. The radiographic parameters including the TAS and TAL showed no statistical significant improvement when compared pre and post operatively. The varus ankle tilt deformity improved from 18 degrees preoperatively to 10 degrees postoperatively (p < 0.05). The pre- and postoperative AOFAS score improved significantly from 46 to 78, respectively (p < 0.05). Two patients underwent ankle arthrodesis at 7 and 36 months, and two patients underwent ankle replacement at 30 and 48 months following the index procedure. Of the remaining 15 patients, 14 reported stable or very stable ankles, and 15 of the 19 were either satisfied or very satisfied with the outcome of treatment.
CONCLUSIONS: These results demonstrate that plafond-plasty osteotomy associated with lateral ligament reconstruction may be a suitable for patients presenting with intra-articular varus ankle osteoarthritis associated with ankle instability, providing pain relief and better function and stability in most patients.
Haroon A Mann; Jorge Filippi; Mark S Myerson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Foot & ankle international     Volume:  33     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-06-27     Completed Date:  2012-08-14     Revised Date:  2014-08-27    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  IM    
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MeSH Terms
Ankle Joint / physiopathology,  surgery*
Arthroplasty, Replacement, Ankle
Follow-Up Studies
Joint Deformities, Acquired / physiopathology,  surgery*
Joint Instability / physiopathology,  surgery*
Ligaments, Articular / surgery
Middle Aged
Osteoarthritis / physiopathology,  surgery*
Osteotomy / methods*
Pain Measurement
Patient Satisfaction
Retrospective Studies
Tibia / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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