title: Cavovarus foot realignment to treat anteromedial ankle arthrosis.
abstract: BACKGROUND
  Adult patients with cavovarus feet were seen with symptomatic anteromedial ankle arthrosis and, frequently, lateral hindfoot instability. Static and dynamic realignment was performed to redistribute joint contact pressures and restore stability.
  
  
  METHODS
  Thirteen patients with fixed cavovarus feet (6 neurogenic, 7 idiopathic; 6 with hindfoot instability, 7 without) and mild to moderate anteromedial ankle arthrosis were treated by osteotomies and tendon transfers but no lateral ligament reconstruction. Anteromedial cheilectomy of the ankle was added to increase dorsiflexion and alleviate anteromedial impingement.
  
  
  RESULTS
  Failure occurred in 2 patients, who required additional procedures. The remaining 11 patients improved from preoperative 45 to 71 points (American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score) at the latest follow-up (average 84 months). Ankle dorsiflexion improved 7 degrees on average. There was no recurrent hindfoot instability and no progression of anteromedial ankle arthrosis over time.
  
  
  CONCLUSIONS
  Cavovarus foot realignment with anteromedial ankle cheilectomy reliably improved patients' symptoms related to ankle arthrosis, restored lateral hindfoot stability, and stabilized the extent of anteromedial ankle arthrosis when talar varus tilt was reduced.
  
  
  METHODS
  Level IV, retrospective case series.
authors: Department of Orthopaedic Surgery, Inselspital, Berne, Switzerland. fabian.krause@iscel.ch
authors: Fabian G
authors: FG
authors: Krause
authors: Julia
authors: J
authors: Henning
authors: Gilles
authors: G
authors: Pfander
authors: Martin
authors: M
authors: Weber
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001168:Arthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005530:Foot Deformities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000601:surgery; D010027:Osteotomy; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013709:Tendon Transfer; D016896:Treatment Outcome