title: Use of Soft-Tissue Procedures for Managing Varus and Valgus Malalignment with Total Ankle Replacement.
abstract: Achieving frontal plane alignment of the ankle joint during total ankle replacement is essential for long-term success. Tendon and ligament lengthening, ligament reinforcement, tendon transfer, nonanatomic tendon transfer ligament reconstruction, and periarticular osteotomies are safe, straightforward, minimally invasive, and reproducible procedures to correct varus and valgus deformities associated with end-stage degenerative joint disease. Using reproducible topographic anatomic landmarks is essential to these techniques properly and limit complications. The approach to frontal plane deformities is stepwise, with liberal use of tendon and ligament lengthening and reconstruction, a low threshold for nonanatomic tendon transfer ligament reconstructions, and tendon transfers and/or periarticular osteotomies.
authors.affiliation: Orthopaedic Center, Gundersen Health System, Mail Stop: CO2-006, 1900 South Avenue, La Crosse, WI 54601, USA. Electronic address: tsroukis@gundersenhealth.org.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Roukis
authors.affiliation: Gundersen Medical Foundation, 1900 South Avenue, La Crosse, WI 54601, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Elliott
mesh_terms: D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects / Q000379:methods*; D017760:Bone Malalignment / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007593:Joint Instability / Q000517:prevention & control; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D013709:Tendon Transfer / Q000379:methods; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome
keywords: Ankle malalignment; Complications; Deformity; Musculotendinous imbalance; Total ankle arthroplasty