Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?

Category: Ankle Arthritis Introduction/Purpose: Preoperative talar valgus deformity increases the technical difficulty of total ankle replacement (TAR) and is associated with an increased failure rate. Deformity of ≥15° has been reported to be a contraindication to arthroplasty. The goal of the pres...

Full description

Saved in:
Bibliographic Details
Published in:Foot & ankle orthopaedics 2018-07, Vol.3 (3)
Main Authors: Halai, Mansur, Mann, Matthew, Khan, Ryan, Pinsker, Ellie, Daniels, Timothy
Format: Article
Language:English
Subjects:
Ankle
Arthritis
Joint surgery
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page
container_issue 3
container_start_page
container_title Foot & ankle orthopaedics
container_volume 3
creator Halai, Mansur
Mann, Matthew
Khan, Ryan
Pinsker, Ellie
Daniels, Timothy
description Category: Ankle Arthritis Introduction/Purpose: Preoperative talar valgus deformity increases the technical difficulty of total ankle replacement (TAR) and is associated with an increased failure rate. Deformity of ≥15° has been reported to be a contraindication to arthroplasty. The goal of the present study was to determine whether the clinical outcomes of TAR for treatment of end-stage ankle arthritis were comparable for patients with preoperative talar valgus deformity of ≥15° as compared to those with
doi_str_mv 10.1177/2473011418S00060
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_9656610d78524b45a2c7b1a4011cdfdb</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2473011418S00060</sage_id><doaj_id>oai_doaj_org_article_9656610d78524b45a2c7b1a4011cdfdb</doaj_id><sourcerecordid>2313769451</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2150-b402bc727a2d4fba02af41d845498fe0c325b5b519a0d85b2eb447e903e71b2c3</originalsourceid><addsrcrecordid>eNp1UU1r3DAQNaWBhCT3HAU9u9XIkmWfSrptmsBCQ76uYiSPN95qV47kPeRf5Tf0l1WbLWkIhDnM8Oa9N_CmKE6AfwbQ-ouQuuIAEpprznnNPxQHW6jcYh9fzfvFcUrLTAGt2rZpDgpzfR82vmOg_jyx0LM79ItNYrMQwxp9eelxTew79SGuhumRfSM23RO7HUeKbD5kjOUVQ3YTJvTsdP3bE7ui0aOjFa2nr0fFXo8-0fG_fljcnv24mZ2X818_L2an89IJULy0kgvrtNAoOtlb5AJ7CV0jlWybnrirhLK5oEXeNcoKslJqanlFGqxw1WFxsfPtAi7NGIcVxkcTcDDPQIgLg3EanCfT1qqugXe6UUJaqVA4bQFlDsh1fWez16ed1xjDw4bSZJZhE3McyYgKKl23UkFm8R3LxZBSpP7lKnCz_Yp5-5UsKXeShAv6b_ou_y-wKYmm</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2313769451</pqid></control><display><type>article</type><title>Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?</title><source>Publicly Available Content Database</source><source>SAGE Open Access Journals</source><creator>Halai, Mansur ; Mann, Matthew ; Khan, Ryan ; Pinsker, Ellie ; Daniels, Timothy</creator><creatorcontrib>Halai, Mansur ; Mann, Matthew ; Khan, Ryan ; Pinsker, Ellie ; Daniels, Timothy</creatorcontrib><description>Category: Ankle Arthritis Introduction/Purpose: Preoperative talar valgus deformity increases the technical difficulty of total ankle replacement (TAR) and is associated with an increased failure rate. Deformity of ≥15° has been reported to be a contraindication to arthroplasty. The goal of the present study was to determine whether the clinical outcomes of TAR for treatment of end-stage ankle arthritis were comparable for patients with preoperative talar valgus deformity of ≥15° as compared to those with &lt;15°. Methods: Fifty ankles with preoperative coronal-plane tibiotalar valgus deformity of ≥15° (“valgus” group) and 50 ankles with valgus deformity of &lt;15° (“control” group) underwent TAR. The cohorts were similar with respect to demographics and components used. All TARs were performed by a single surgeon. The mean duration of clinical follow-up was 5.5 years (minimum two years). Preoperative and postoperative radiographic measurements of coronal-plane deformity, Ankle Osteoarthritis Scale (AOS) scores and Short Form (SF)-36 scores were prospectively recorded. All ancillary (intraoperative) and secondary procedures, complications and measurements were collected. Results: The AOS pain and disability subscale scores decreased significantly in both groups. The improvement in AOS and SF-36 scores did not differ significantly between the groups at the time of the final follow-up. The valgus group underwent more ancillary procedures during the index surgery (80% vs 26%). Tibio-talar deformity improved significantly toward a normal weight-bearing axis in the valgus group. Secondary postoperative procedures were more common in the valgus group (36%) than the controls (20%). Overall, re-operation was not associated with poorer patient outcome scores. Metal component revision surgery occurred in seven patients (three valgus and four controls). These revisions included two deep infections (2%), one in each group, which were converted to hindfoot fusions. Therefore, 94% of the valgus group retained their original components at final follow-up. Conclusion: Satisfactory midterm results were achieved in patients with valgus mal-alignment of ≥15°. The valgus cohort required more procedures during and after their TAR, as well as receiving more novel techniques to balance their TAR. Whilst longer term studies are needed, valgus coronal-plane alignment of ≥15° should not be considered an absolute contraindication to TAR if the associated deformities are addressed.</description><identifier>ISSN: 2473-0114</identifier><identifier>EISSN: 2473-0114</identifier><identifier>DOI: 10.1177/2473011418S00060</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Ankle ; Arthritis ; Joint surgery</subject><ispartof>Foot &amp; ankle orthopaedics, 2018-07, Vol.3 (3)</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2473011418S00060$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2313769451?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,21945,25731,27830,27901,27902,36989,44566,44921,45309</link.rule.ids></links><search><creatorcontrib>Halai, Mansur</creatorcontrib><creatorcontrib>Mann, Matthew</creatorcontrib><creatorcontrib>Khan, Ryan</creatorcontrib><creatorcontrib>Pinsker, Ellie</creatorcontrib><creatorcontrib>Daniels, Timothy</creatorcontrib><title>Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?</title><title>Foot &amp; ankle orthopaedics</title><description>Category: Ankle Arthritis Introduction/Purpose: Preoperative talar valgus deformity increases the technical difficulty of total ankle replacement (TAR) and is associated with an increased failure rate. Deformity of ≥15° has been reported to be a contraindication to arthroplasty. The goal of the present study was to determine whether the clinical outcomes of TAR for treatment of end-stage ankle arthritis were comparable for patients with preoperative talar valgus deformity of ≥15° as compared to those with &lt;15°. Methods: Fifty ankles with preoperative coronal-plane tibiotalar valgus deformity of ≥15° (“valgus” group) and 50 ankles with valgus deformity of &lt;15° (“control” group) underwent TAR. The cohorts were similar with respect to demographics and components used. All TARs were performed by a single surgeon. The mean duration of clinical follow-up was 5.5 years (minimum two years). Preoperative and postoperative radiographic measurements of coronal-plane deformity, Ankle Osteoarthritis Scale (AOS) scores and Short Form (SF)-36 scores were prospectively recorded. All ancillary (intraoperative) and secondary procedures, complications and measurements were collected. Results: The AOS pain and disability subscale scores decreased significantly in both groups. The improvement in AOS and SF-36 scores did not differ significantly between the groups at the time of the final follow-up. The valgus group underwent more ancillary procedures during the index surgery (80% vs 26%). Tibio-talar deformity improved significantly toward a normal weight-bearing axis in the valgus group. Secondary postoperative procedures were more common in the valgus group (36%) than the controls (20%). Overall, re-operation was not associated with poorer patient outcome scores. Metal component revision surgery occurred in seven patients (three valgus and four controls). These revisions included two deep infections (2%), one in each group, which were converted to hindfoot fusions. Therefore, 94% of the valgus group retained their original components at final follow-up. Conclusion: Satisfactory midterm results were achieved in patients with valgus mal-alignment of ≥15°. The valgus cohort required more procedures during and after their TAR, as well as receiving more novel techniques to balance their TAR. Whilst longer term studies are needed, valgus coronal-plane alignment of ≥15° should not be considered an absolute contraindication to TAR if the associated deformities are addressed.</description><subject>Ankle</subject><subject>Arthritis</subject><subject>Joint surgery</subject><issn>2473-0114</issn><issn>2473-0114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1UU1r3DAQNaWBhCT3HAU9u9XIkmWfSrptmsBCQ76uYiSPN95qV47kPeRf5Tf0l1WbLWkIhDnM8Oa9N_CmKE6AfwbQ-ouQuuIAEpprznnNPxQHW6jcYh9fzfvFcUrLTAGt2rZpDgpzfR82vmOg_jyx0LM79ItNYrMQwxp9eelxTew79SGuhumRfSM23RO7HUeKbD5kjOUVQ3YTJvTsdP3bE7ui0aOjFa2nr0fFXo8-0fG_fljcnv24mZ2X818_L2an89IJULy0kgvrtNAoOtlb5AJ7CV0jlWybnrirhLK5oEXeNcoKslJqanlFGqxw1WFxsfPtAi7NGIcVxkcTcDDPQIgLg3EanCfT1qqugXe6UUJaqVA4bQFlDsh1fWez16ed1xjDw4bSZJZhE3McyYgKKl23UkFm8R3LxZBSpP7lKnCz_Yp5-5UsKXeShAv6b_ou_y-wKYmm</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Halai, Mansur</creator><creator>Mann, Matthew</creator><creator>Khan, Ryan</creator><creator>Pinsker, Ellie</creator><creator>Daniels, Timothy</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><general>SAGE Publishing</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>DOA</scope></search><sort><creationdate>20180701</creationdate><title>Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?</title><author>Halai, Mansur ; Mann, Matthew ; Khan, Ryan ; Pinsker, Ellie ; Daniels, Timothy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2150-b402bc727a2d4fba02af41d845498fe0c325b5b519a0d85b2eb447e903e71b2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Ankle</topic><topic>Arthritis</topic><topic>Joint surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Halai, Mansur</creatorcontrib><creatorcontrib>Mann, Matthew</creatorcontrib><creatorcontrib>Khan, Ryan</creatorcontrib><creatorcontrib>Pinsker, Ellie</creatorcontrib><creatorcontrib>Daniels, Timothy</creatorcontrib><collection>SAGE Open Access Journals</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Foot &amp; ankle orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Halai, Mansur</au><au>Mann, Matthew</au><au>Khan, Ryan</au><au>Pinsker, Ellie</au><au>Daniels, Timothy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?</atitle><jtitle>Foot &amp; ankle orthopaedics</jtitle><date>2018-07-01</date><risdate>2018</risdate><volume>3</volume><issue>3</issue><issn>2473-0114</issn><eissn>2473-0114</eissn><abstract>Category: Ankle Arthritis Introduction/Purpose: Preoperative talar valgus deformity increases the technical difficulty of total ankle replacement (TAR) and is associated with an increased failure rate. Deformity of ≥15° has been reported to be a contraindication to arthroplasty. The goal of the present study was to determine whether the clinical outcomes of TAR for treatment of end-stage ankle arthritis were comparable for patients with preoperative talar valgus deformity of ≥15° as compared to those with &lt;15°. Methods: Fifty ankles with preoperative coronal-plane tibiotalar valgus deformity of ≥15° (“valgus” group) and 50 ankles with valgus deformity of &lt;15° (“control” group) underwent TAR. The cohorts were similar with respect to demographics and components used. All TARs were performed by a single surgeon. The mean duration of clinical follow-up was 5.5 years (minimum two years). Preoperative and postoperative radiographic measurements of coronal-plane deformity, Ankle Osteoarthritis Scale (AOS) scores and Short Form (SF)-36 scores were prospectively recorded. All ancillary (intraoperative) and secondary procedures, complications and measurements were collected. Results: The AOS pain and disability subscale scores decreased significantly in both groups. The improvement in AOS and SF-36 scores did not differ significantly between the groups at the time of the final follow-up. The valgus group underwent more ancillary procedures during the index surgery (80% vs 26%). Tibio-talar deformity improved significantly toward a normal weight-bearing axis in the valgus group. Secondary postoperative procedures were more common in the valgus group (36%) than the controls (20%). Overall, re-operation was not associated with poorer patient outcome scores. Metal component revision surgery occurred in seven patients (three valgus and four controls). These revisions included two deep infections (2%), one in each group, which were converted to hindfoot fusions. Therefore, 94% of the valgus group retained their original components at final follow-up. Conclusion: Satisfactory midterm results were achieved in patients with valgus mal-alignment of ≥15°. The valgus cohort required more procedures during and after their TAR, as well as receiving more novel techniques to balance their TAR. Whilst longer term studies are needed, valgus coronal-plane alignment of ≥15° should not be considered an absolute contraindication to TAR if the associated deformities are addressed.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><doi>10.1177/2473011418S00060</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2473-0114
ispartof Foot & ankle orthopaedics, 2018-07, Vol.3 (3)
issn 2473-0114
2473-0114
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_9656610d78524b45a2c7b1a4011cdfdb
source Publicly Available Content Database; SAGE Open Access Journals
subjects Ankle
Arthritis
Joint surgery
title Should 15° of Valgus Coronal-Plane Deformity Be the Upper Limit for a Total Ankle Replacement?
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T04%3A57%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Should%2015%C2%B0%20of%20Valgus%20Coronal-Plane%20Deformity%20Be%20the%20Upper%20Limit%20for%20a%20Total%20Ankle%20Replacement?&rft.jtitle=Foot%20&%20ankle%20orthopaedics&rft.au=Halai,%20Mansur&rft.date=2018-07-01&rft.volume=3&rft.issue=3&rft.issn=2473-0114&rft.eissn=2473-0114&rft_id=info:doi/10.1177/2473011418S00060&rft_dat=%3Cproquest_doaj_%3E2313769451%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c2150-b402bc727a2d4fba02af41d845498fe0c325b5b519a0d85b2eb447e903e71b2c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2313769451&rft_id=info:pmid/&rft_sage_id=10.1177_2473011418S00060&rfr_iscdi=true