Ligament reconstruction and calcaneal osteotomy for osteoarthritis of the ankle.

Background: The purpose of this study was to investigate the clinical and radiological results of calcaneal osteotomy, joint debridement and ligament reconstruction for the treatment of early to moderate stage osteoarthritis of the ankle.

Methods: Eleven cases with osteoarthritis of the ankle, four with stage 2 and seven with stage 3, underwent joint debridement, cheilectomy, calcaneal osteotomy, deltoid ligament release, and lateral ligament reconstruction. The mean followup was 22.3 (range, 15 to 42) months. The American Orthopaedic Foot and Ankle Society(AOFAS) clinical ankle-hindfoot scale was used to evaluate clinical function of the ankle. Weightbearing anteroposterior and hindfoot alignment radiographs were evaluated for measuring of tibiotalar tilt angles, clear space ratio, heel alignment ratio preoperatively and at the last followup.

Results: The mean AOFAS score improved from 42.8 points before surgery to 82.7 points at the last followup. The mean talar tilt angles improved from 7.4 degrees to 5.9 degrees. The mean medial clear space widened from 0.4 mm to 2.7 mm. The lateral clear space was narrowed from 6.8 mm to 4.8 mm. The medial to lateral clear space ratio of ankle was improved from 0.06 to 0.62. Heel alignment ratio was improved from 0.59 to 0.36.

Conclusions: Calcaneal osteotomy with ligament reconstruction can be considered for treatment of the early stages of osteoarthritis of the ankle.