Intra-articular opening medial tibial wedge osteotomy (plafond-plasty) for the treatment of intra-articular varus ankle arthritis and instability

Haroon A Mann, Jorge Filippi, Mark S Myerson
Foot & Ankle International 2012, 33 (4): 255-61

BACKGROUND: Although supramalleolar osteotomy with an opening medial wedge or a closing lateral wedge have been described for varus ankle deformity, these may be associated with failure due to persistence of the medial intra-articular defect, resulting in recurrent varus deformity. We report the results of a retrospective study assessing the outcome of an intra-articular opening wedge osteotomy of the distal medial tibia (plafond-plasty) for intra-articular varus ankle deformity associated with osteoarthritis and ankle instability.

METHOD: The results of 19 plafond-plasties in 19 patients for correction of intra-articular varus osteoarthritis of the ankle associated with ankle instability were reviewed. Fourteen men and five women of a mean age of 47 (range, 32 to 63) years were treated. Followup ranged from 14 to 98 (mean, 59) months.

RESULTS: Lateral ligament reconstruction was done at the time of the surgery in 18 out of 19 patients. The radiographic parameters including the TAS and TAL showed no statistical significant improvement when compared pre and post operatively. The varus ankle tilt deformity improved from 18 degrees preoperatively to 10 degrees postoperatively (p < 0.05). The pre- and postoperative AOFAS score improved significantly from 46 to 78, respectively (p < 0.05). Two patients underwent ankle arthrodesis at 7 and 36 months, and two patients underwent ankle replacement at 30 and 48 months following the index procedure. Of the remaining 15 patients, 14 reported stable or very stable ankles, and 15 of the 19 were either satisfied or very satisfied with the outcome of treatment.

CONCLUSIONS: These results demonstrate that plafond-plasty osteotomy associated with lateral ligament reconstruction may be a suitable for patients presenting with intra-articular varus ankle osteoarthritis associated with ankle instability, providing pain relief and better function and stability in most patients.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"