title: Mid- to Long-term Results of Supramalleolar Osteotomy.
abstract: BACKGROUND
  Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery.
  
  
  METHODS
  Two hundred ninety-four patients (298 ankles) underwent realignment surgery between December 1999 and June 2013. Kaplan-Meier survival analysis was performed with total ankle replacement and arthrodesis of the ankle joint as endpoints. A Cox proportional hazards model was performed to identify risk factors for failure. The mean time to follow-up was 5.0 ± 3.7 years.
  
  
  RESULTS
  The overall 5-year survival rate was 88%. Thirty-eight patients (12.9%) underwent either secondary total ankle replacement or ankle arthrodesis (30 total ankle replacements, 8 ankle arthrodesis). Risk factors for failure following realignment surgery were age at the time of surgery and a Takakura score of 3b preoperatively.
  
  
  CONCLUSIONS
  Realignment surgery of the hindfoot was an excellent treatment option for young and physically active patients with early to mid-stage ankle OA.
  
  
  METHODS
  Level IV, prospective observational study.
authors.affiliation: 1 Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Krähenbühl
authors.affiliation: 1 Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Zwicky
authors.affiliation: 1 Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Lilianna
authors.initials: L
authors.lastname: Bolliger
authors.affiliation: 2 Clinical Trial Unit, University Hospital Basel, Basel, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schädelin
authors.affiliation: 1 Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Hintermann
authors.affiliation: 1 Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Liestal, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Knupp
mesh_terms: D000328:Adult; D000842:Ankle / Q000000981:diagnostic imaging; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis; D000075202:Contraindications; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007595:Joint Prosthesis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D012086:Reoperation
keywords: ankle osteoarthrosis; hindfoot deformity; realignment surgery; supramalleolar osteotomy