title: Ankle Fusion Combined With Calcaneal Sliding Osteotomy for Severe Arthritic Ball and Socket Ankle Deformity.
abstract: BACKGROUND
  Although a ball and socket ankle deformity is usually congenital and asymptomatic, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis. This retrospective study was performed to evaluate the clinical and radiologic outcomes of ankle fusion combined with calcaneal sliding osteotomy for severe arthritic ball and socket ankle deformity.
  
  
  METHODS
  Fourteen patients with severe arthritic ball and socket ankle deformity were followed for more than 3 years after operation. The clinical evaluation consisted of American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. The period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically.
  
  
  RESULTS
  AOFAS and FAAM scores were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. The average satisfaction score of patients was 88.9 points. The difference in heel alignment angle (compared to contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion.
  
  
  CONCLUSIONS
  Ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis. In spite of increased complication rate, reliable pain relief, and restoration of gait ability through correcting hindfoot malalignment could improve the quality of life.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea titanick25@naver.com.
authors.forename: Byung-Ki
authors.initials: BK
authors.lastname: Cho
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Kyoung-Jin
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Seung-Myung
authors.initials: SM
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Hyung-Ki
authors.initials: HK
authors.lastname: Lee
mesh_terms: D000368:Aged; D016512:Ankle Injuries / Q000150:complications; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies
keywords: ankle; ball and socket deformity; calcaneal osteotomy; fusion; osteoarthritis