Backgrounds: Plafond-plasty is a joint-preserving procedure to treat varus ankle osteoarthritis (OA) with asymmetrical joint involvement. The aim of this systematic review and meta-analysis was to evaluate indications, different surgical techniques, associated procedures, and results of plafond-plasty in varus ankle OA and to analyze the level of evidence (LOE) and quality of evidence (QOE) of the included studies.
Methods: A systematic review of the literature was performed using MEDLINE, Embase, and Cochrane.
Results: Five studies evaluating 99 ankles were included. A non-rigid varus ankle deformity and an ankle OA Takakura stage 3b or less were the most recommended pre-operative indications. Meta-analysis showed a significant post-operative improvement in clinical and radiological parameters. Many associated surgical procedures have been reported, the most frequent being medial additional supramalleolar osteotomy and lateral ankle ligament reconstruction. The level of evidence and methodological quality assessment of the included studies showed an overall low quality.
Conclusion: Plafond-plasty seems to be a promising surgical option when managing varus ankle OA with asymmetrical joint involvement, extending the indications for joint sparing surgery. Additional associated procedures should be carefully evaluated case-by-case.
Levels Of Evidence: .
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http://dx.doi.org/10.1177/19386400241236321 | DOI Listing |
J Exp Orthop
January 2025
Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland.
Purpose: The goals of this study were (1) to assess whether the preoperative difference between modalities and extent of deformity are associated with a higher difference between planned and achieved surgical correction and (2) if they yield a higher probability of intraoperative adjustments.
Methods: Retrospective single-centre analysis of patients undergoing patient-specific instrumented (PSI) total knee arthroplasty (TKA). Preoperative radiographic parameters were analysed on weightbearing (WB) long-leg radiographs (LLR) and nonweightbearing (NWB) computed tomography (CT).
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
Purpose: Lateral unicompartmental knee arthroplasty (UKA) is relatively less common than medial UKA. There has been no comparative analysis of the constitutional phenotypes of knees that underwent medial and lateral UKA. Therefore, this study aimed to compare the Coronal Plane Alignment of the Knee (CPAK) classification of knees that underwent medial and lateral UKA.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Nopparat Rajathanee Hospital, Bangkok, Thailand.
Background: Understanding optimal prosthesis alignment in TKA remains crucial despite ongoing debate. While current research focuses on osteoarthritic knees, a gap exists in characterizing healthy young adult knees in Asians. This study aims to fill this gap by identifying the distribution of CPAK phenotypes in this population, including potential gender variations and individual differences.
View Article and Find Full Text PDFJ Clin Orthop Trauma
January 2025
St John of God Subiaco and Midland Hospitals, Subiaco, 6008, WA, Australia.
Introduction: Total knee arthroplasty (TKA) in severe varus deformity still remains a challenge. Alternative alignment TKA aims to improve outcomes and satisfaction. The purpose of this study is to report on the outcomes of a functionally aligned TKA in severe varus deformity.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
Ankara Etlik Şehir Hastanesi Ortopedi ve Travmatoloji Kliniği, 06170 Yenimahalle, Ankara, Türkiye.
Objectives: This study aims to compare the radiographic results with and without postoperative metal augmentation in varus knee patients with primary total knee arthroplasty (TKA) with a hip-knee-ankle (HKA) angle >10° and to determine a cut-off value using radiographic parameters to predict the need for metal augmentation.
Patients And Methods: Between October 2022 and April 2024, a total of 87 knees (51 right and 36 left) of 82 patients (11 males, 71 females; mean age: 68.7±8 years; range, 53 to 86 years) who underwent primary TKA were retrospectively analyzed.
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