title: Effect of Combined Fibular Osteotomy on the Pressure of the Tibiotalar and Talofibular Joints in Supramalleolar Osteotomy of the Ankle: A Cadaveric Study.
abstract: We investigated the effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in medial opening-wedge supramalleolar osteotomy. Three different tibial osteotomy gaps (6, 8, and 10 mm) were created in 10 cadaveric models, and the pressure in the tibiotalar and talofibular joints was measured under axial load before and after fibular osteotomy. The heel alignment angle and talar translation ratio were evaluated radiographically. An increase in osteotomy gap led to increases in hindfoot valgus (p = .001) and the contact and peak pressures in the talofibular joint (p = .03 and p = .004). In contrast, the contact and peak pressures in the tibiotalar joint were unchanged with an increasing osteotomy gap (p = .52 and p = .76). Fibular osteotomy reduced the contact and peak pressures in the talofibular joint (p < .001 and p = .001, respectively), and it did not influence the contact and peak pressures in the tibiotalar joint (p = .46 and p = .14, respectively). Therefore, fibular osteotomy might be necessary in supramalleolar osteotomy for medial ankle arthritis to minimize the increase in pressure in the talofibular joint, especially when the osteotomy gap is large.
authors.affiliation: Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, South Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, South Korea. Electronic address: soonlee@korea.ac.kr.
authors.forename: Soon Hyuck
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Inje University Ilsanpaik Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors.forename: Kyung Wook
authors.initials: KW
authors.lastname: Nha
authors.affiliation: Department of Biomedical Engineering, Inje University, Gimhae-si, Gyeongsangnam-do, South Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Biomedical Engineering, Inje University, Gimhae-si, Gyeongsangnam-do, South Korea.
authors.forename: Won Hyeon
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Department of Anatomy, College of Medicine, Korea University, Seoul, South Korea.
authors.forename: Chang-Sub
authors.initials: CS
authors.lastname: Uhm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D001696:Biomechanical Phenomena; D002102:Cadaver; D003131:Combined Modality Therapy; D019245:Compressive Strength; D005260:Female; D005360:Fibula / Q000601:surgery*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000601:surgery*
keywords: ankle joint; joint contact pressure; pressure sensor; supramalleolar osteotomy