Outcomes of intermediate stage varus ankle arthritis treated by supramalleolar osteotomy

Objective To evaluate the outcomes of intermediate stage varus ankle arthritis treated by supramalleolar osteotomy. Methods Clinical data of 57 patients with varus arthritis who underwent supramalleolar osteotomy at our hospital between March 2018 and December 2019 were retrospectively analyzed. The patients were grouped according to the Takakura classification, and assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and the Visual Analogue Score (VAS). Tibial anterior surface (TAS) angle and talar tilt (TT) angle were measured at the weight-bearing anteroposterior view. Tibial lateral surface (TLS) angle was measured at the weight-bearing lateral view. The differences in the above indicators of patients with different stages of varus ankle arthritis before and after treatment were analyzed. Results The patients were followed up for an average of 31.9 +/- 5.8 months. Upon the last follow-up, the AOFAS score was 84.1 +/- 9.7, the VAS score 2.2 +/- 1.3, the TAS angle 92.4 +/- 5.5 degrees, the TLS angle 79.3 +/- 5.3 degrees, and the TT angle 3.7 +/- 3.4 degrees, which were significantly different from the preoperative levels (64.2 +/- 14.6, 4.5 +/- 1.8, 80.5 +/- 6.7 degrees, 74.9 +/- 4.6 degrees, and 5.2 +/- 64.1 degrees, respectively) (p < .05). There were significant differences in AOFAS and VAS scores before surgery and upon the last follow-up in each group (p < .05). The postoperative TT angle was significantly different from the preoperative level in stage IIIb patients (p = .003). Conclusions Supramalleolar osteotomy achieved good short-to mid-term clinical outcomes for intermediate stage varus ankle arthritis. This procedure could significantly improve the TAS and TLS angles of the patients at any stage and the TT angle of stage IIIb patients.