Clinical and radiographic outcomes of supramalleolar osteotomy with or without fibular osteotomy in the treatment of varus ankle osteoarthritis: a single-center retrospective study

This study aims to compare the clinical efficacy, ankle function, radiographic parameters, and lower limb alignment changes between supramalleolar osteotomy alone and that combined with fibular osteotomy in the treatment of varus ankle osteoarthritis, and to provide a reference for clinical decision-making. This was a continuous retrospective analytical single-center study performed in the orthopedic surgery unit of the Hospital. The American orthopedic foot and ankle society (AOFAS)ankle—hind score, and Visual Analogue Scale (VAS) were used for pre—and postoperative functional evaluation as well as the range of motion (ROM)of ankle on sagittal plane. The tibial anterior surface angle (TAS), talar tilt angle (TT), medial displacement of the talus (MDT), knee joint congruence (JLCA) angle and hip-knee-ankle (HKA) angle were evaluated pre—and postoperatively. The remaining 28 patients in Group I and 27 in Group II were included in the final analysis. fter surgery, the clinical and radiographic parameters of both groups were significantly improved compared with preoperative values (P < 0.05). The range of motion (ROM) of the ankle joint decreased postoperatively in both groups, but there was no significant difference in postoperative ROM between the two groups (P > 0.05). Compared with the SMOT alone group, the SMOT + FO group had significantly higher postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores, lower medial distal tibial angle (MDL), and more improved knee joint line convergence angle (JLCA) (all P < 0.05). The significant correlations were found between the AOFAS and MDT changes(r=-0.341,P = 0.011). Both SMO alone and SMO + FO can effectively alleviate pain and improve ankle function in patients with varus ankle osteoarthritis. The SMO + FO approach has advantages in improving AOFAS scores, MDL, and JLCA, suggesting that it may be a more optimal surgical option for patients with specific indications.