Sports and recreation activity of varus and valgus ankle osteoarthritis before and after realignment surgery.
BACKGROUND
Realignment-surgery to unload ankle osteoarthritis (OA) has been proposed as treatment alternative for varus and valgus ankle OA. Sports activity after this procedure has not been analyzed. Realignment-surgery increases sports activity. Sports activity correlates with ankle pain, function, and alignment, but does not influence revision rate.


METHODS
Prospective case series of 35 consecutive patients with post-traumatic varus or valgus ankle OA limited to half tibiotalar joint surface were treated by OA unloading realignment-surgery. Distal tibia osteotomy was used in all cases; additional osteotomies, tendon, ligament procedures in 92% of cases.


METHODS
Pain (visual-analogue-scale; VAS), ankle range-of-motion (ROM); function (American-Orthopaedic-Foot-and-Ankle-Society (AOFAS) ankle-score; Swiss-symptom-related-Ankle-Activity-Scale (SAAS); Sports-Frequency-Score (SFS), OA and tibiotalar-alignment-grade (Takakura-Score), and revision surgery. Mean followup was 5 years.


RESULTS
Mean values from preoperative to followup: VAS decreased (p = 0.0001) 4 points; ankle ROM increased (p = 0.001) 5 degrees; AOFAS-Score increased (p = 0.0001) 46 points; SAAS increased (p = 0.0001) 42 points; SFS increased (p = 0.02) 0.5 grades; Takakura-score decreased (p = 0.0001) 1.0 grades. Revision surgery was performed in 10 cases (29%). Three of these were revised to ankle arthroplasty. At follow-up, SAAS correlated with VAS, AOFAS score, Takakura score, and not with ROM or SFS. SFS did not correlate with other variables. Patients needing revision surgery had a higher (p = 0.003) SFS than patients who needed no revision.


CONCLUSIONS
Realignment-surgery increased sports activity of ankle OA patients. Improved ankle pain and function correlated with ability to perform activity without symptoms; however, sports frequency had no correlation to patients' symptoms but showed higher revision rate.
Pagenstert
Geert
G
University of Basel, Kantonsspital Liestal, Orthopedic Surgery, Rheinstrasse 26, Liestal, 4410, Switzerland. geert.pagenstert@ksli.ch
Leumann
André
A
Hintermann
Beat
B
Valderrabano
Victor
V
D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D011998:Recreation; D012086:Reoperation; D013177:Sports; D016896:Treatment Outcome