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Updated: Jan 22, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Supramalleolar Osteotomy in Patients with Varus Ankle Osteoarthritis
Woo-Chun Lee1, Jeong-Seok Moon1, Kang Lee1
1Department of Orthopaedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Number 85, 2-ga, Jeo-dong, Jung-Gu, Seoul, 100-032, South Korea. E-mail address for W.-C. Lee: lwsk980@unitel.co.kr.
Introduction:
Supramalleolar osteotomies have been reported to be effective in the treatment of moderate primary and traumatic osteoarthritis of the ankle joint.
Step 1 Arthroscopic Examination:
Perform an arthroscopic examination prior to the osteotomy in every patient to evaluate the status of the articular cartilage of the tibia and talus.
Step 2 Fibular Osteotomy:
Bend a seven-hole plate slightly more than the natural contour of the distal part of the fibula, insert screws, and complete the osteotomy.
Step 3 Tibial Osteotomy:
Attempt to achieve a tibial-talar angle of 95° (5° of valgus).
Step 4 Fixation And Bone-Grafting Of Tibial Osteotomy Site:
Apply a seven-hole plate and pack graft into the osteotomy gap.
Step 5 Postoperative Care:
After routine wound closure, apply a short leg cast and do not allow weight-bearing for six weeks after surgery.
Results:
In our series of sixteen patients with moderate medial ankle osteoarthritis, the mean American Orthopaedic Foot & Ankle Society (AOFAS) score, radiographic stage, and values for all radiographic parameters measured improved significantly after surgery.
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
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