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Titre : | Deciding Between Ankle and Tibiotalocalcaneal Arthrodesis for Isolated Ankle Arthritis (2022) |
Auteurs : | Manuel Monteagudo ; Pilar Martínez-de-Albornoz |
Type de document : | Article |
Dans : | Foot and Ankle Clinics (Vol. 27, n° 1, March 2022) |
Article en page(s) : | p. 217-231 |
Note générale : | https://doi.org/10.1016/j.fcl.2021.11.012 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Arthrite ; Cheville ; Osteotomie |
Résumé : |
Osteotomies around the ankle (supramalleolar and calcaneal) and total ankle replacement are challenging arthrodesis as the gold standard treatment of end-stage ankle arthritis.
Recent meta-analyses reveal that replacements and arthrodesis may achieve similar clinical outcomes, although the incidence of reoperation and major surgical complications is still higher with replacements. After an isolated ankle (tibiotalar) arthrodesis, the triceps will progressively shift the subtalar into varus thus blocking compensatory motion from the midtarsal joints. Subtalar varus with arthritis is the main complication after tibiotalar arthrodesis. In a tibiotalocalcaneal arthrodesis, the subtalar joint may be fixed in the correct valgus position. The comparison between ankle and tibiotalocalcaneal arthrodesis does not clearly favor one over another in terms of pain relief, patient satisfaction, and gait analysis. Compensatory sagittal plane motion through the midtarsal joints when the subtalar is fixed in valgus may be responsible for these matched results. In the last few years, our threshold for indicating tibiotalocalcaneal over isolated tibiotalar arthrodesis has been lower and lower to finally become our procedure of choice regardless of the radiographic state of the subtalar joint. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S1083751521001546 |