[Current status, hotspots and prospects of supramalleolar osteotomy for varus ankle arthritis]

Ankle arthritis is mainly secondary to trauma and is often associated with varus deformity. Patients with ankle arthritis are generally younger than those with hip and knee osteoarthritis, making its clinical management a growing focus in foot and ankle surgery. Current evidence demonstrates that supramalleolar osteotomy can effectively correct varus deformity, enhance postoperative functional outcomes, and even reverse the radiographic stage of arthritis in selected cases. This article provides a comprehensive analysis of critical issues in managing varus ankle arthritis, including three-dimensional deformity assessment, compensatory mechanisms of hindfoot and subtalar joint alignment, management of concomitant subchondral cysts, and optimization of lower limb mechanical axis, aiming to guide clinicians in the rational selection of surgical procedures and improving prognosis. With advancements in medical imaging, computer technology, biomechanical research, and materials science, supramalleolar osteotomy is expected to become a safer, more effective, and more widely applicable core ankle-preserving treatment for varus ankle osteoarthritis.