title: Early results after tibialis anterior tendon transfer for severe varus in total ankle replacement.
abstract: BACKGROUND
  Treatment of severe ankle arthritis with varus malalignment remains controversial.
  
  
  METHODS
  In 14 consecutive total ankle replacements (TAR) with tibiotalar varus malalignment of above 15 (range, 16 to 41) degrees, a complete transfer of the tibialis anterior tendon together with other soft-tissue and bony realignment measures was added to the primary procedure.
  
  
  RESULTS
  After mean followup time of 33.4 (range, 21 to 49) months, only one case showed minor tibiotalar tilt in the frontal plane. The overall clinical results were good to excellent in all but two cases with an average AOFAS-score of 86.4 (range, 70 to 98) points. However, three cases of tibial nerve neuropathy due to entrapment or overtensioning were observed; one of these cases developed clinical problems with incomplete recovery.
  
  
  CONCLUSIONS
  Tibialis anterior tendon transfer can be recommended in conjunction with TAR in cases of varus malalignment with severe muscular or ligamentous imbalance with neuropathy of the tibial nerve being the main complication.
authors: Zentrum Fuß- und Sprunggelenkschirurgie, Englschalkingerstraße 12, München, Germany. J.Hamel@t-online.de
authors: Johannes
authors: J
authors: Hamel
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001168:Arthritis / Q000601:surgery; D058737:Arthroplasty, Replacement, Ankle; D060750:Bone Anteversion / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013709:Tendon Transfer / Q000009:adverse effects / Q000379:methods*; D020429:Tibial Neuropathy / Q000209:etiology