title: Realignment surgery for severe talar tilt secondary to paralytic cavovarus.
abstract: BACKGROUND
  Realignment surgeries for mild to moderate ankle osteoarthritis with minimal talar tilt have been reported to be effective. However, there has been no report on joint-sparing surgery of ankle osteoarthritis in patients with paralytic disorders who have severe talar tilt. We therefore investigated whether ankle osteoarthritis with severe talar tilt caused by paralytic disorders can be improved after operative treatment.
  
  
  METHODS
  This study included 12 ankles (11 patients) with varus ankle osteoarthritis from paralytic disorders with cavovarus deformity of the foot. Mean follow-up period was 3.0 years (range, 2-4.5 years). Causes of paralysis were residual polio in 7 ankles (6 patients), cerebral palsy in 2 ankles, and idiopathic in 3 ankles. Preoperative and postoperative clinical assessments were performed using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and a visual analogue scale (VAS). The Ankle Osteoarthritis Scale (AOS) was used for postoperative assessment. Pre- and postoperative radiographic parameters were compared.
  
  
  RESULTS
  Mean AOFAS score improved from 39.1 (range, 32-57) preoperatively to 77.9 (range, 72-85) postoperatively. Mean talar tilt improved from 17.4 degrees (range, 9.5-33.5 degrees) to 1.4 degrees (range, 0-4 degrees). Degree of osteoarthritis according to Takakura classification improved in all ankles except two. Mean heel alignment angle was reduced from 40.4 degrees (range, 2-65 degrees) of varus preoperatively to 11.2 degrees (range, -3 to 25.5 degrees) of varus postoperatively.
  
  
  CONCLUSIONS
  Medial varus ankle osteoarthritis from paralytic cavovarus may be improved even in cases of severe talar tilt.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Department of Orthopaedic Surgery, Seoul Paik Hospital, Institute for Research of Foot and Ankle Diseases, Inje University, Seoul, South Korea.
authors.forename: Woo-Chun
authors.initials: WC
authors.lastname: Lee
authors.forename: Ji-Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Cho
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Park
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology* / Q000601:surgery*; D001174:Arthrodesis; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery; D010027:Osteotomy; D010243:Paralysis / Q000503:physiopathology*; D012189:Retrospective Studies; D013709:Tendon Transfer; D013710:Tendons / Q000601:surgery; D064232:Visual Analog Scale
keywords: ankle; osteoarthritis; paralytic disorders