| Abstract [eng] |
Author: Agnius Stulpinas Academic supervisor: Aleksas Makulavičius MD, PhD. Work was made at: Vilnius University Faculty of Medicine, Republican Vilnius university hospital Title: Choice of surgical treatment method for the end-stage ankle joint osteoarthritis. Literature review and comparison of typical cases. Aim: Describe typical cases of end-stage ankle osteoarthritis and their surgical treatment: supramalleolar osteotomy, ankle arthroplasty and ankle arthrodesis, and review the surgical treatment methods for end-stage ankle osteoarthritis described in the literature, and compare the indications for their use. Methods: Analysis of clinical cases of patients treated at Republican Vilnius University Hospital and review of scientific literature using “PubMed”, “ScienceDirect“ and “Medscape” databases. Conclusions: Supramalleolar osteotomy is used to realign the ankle joint when there is asymmetric localized osteoarthritis of the ankle joint, and one side of the joint is better preserved and there is an inappropriate loading axis of the ankle joint. It is also used for joint realignment before a subsequent total ankle arthroplasty. Total ankle arthroplasty is reserved for lower demand patients with sufficient ankle joint mobility, good subchondral bone quality, without severe comorbidities (which would affect the survival of the ankle endoprosthesis), and patients who are likely to adhere to a strict post-operative regimen (no smoking, gradual increase in ankle weight-bearing). Ankle arthrodesis is indicated in cases when supramalleolar osteotomy or total ankle arthroplasty is contraindicated due to severe ankle contracture, poor bone quality and the presence of other severe comorbidities or likely non-compliance with the postoperative regimen, which would lead to poor EP survival. |
