Total Ankle Arthroplasty With Valgus Deformity.

BACKGROUND: A substantial coronal plane deformity is common in the context of end-stage ankle osteoarthritis. Recent literature shows a trend toward extending the indication of total ankle arthroplasty in increasingly severe coronal deformities, showing promising results when correct alignment is achieved. Nevertheless, the results of lateral transfibular total ankle replacement (LTTAR) in valgus has not been extensively studied. We aimed to evaluate if the outcomes of LTTAR in ankles with valgus deformity were similar to those with no major deformity at short-term follow-up. METHODS: This retrospective cohort study included 228 LTTARs. Patients were classified into 2 groups according to the preoperative coronal plane tibiotalar angle (TTS): neutral (less than 10 degrees of coronal deformity, 209 patients) and valgus (above 10 degrees of valgus, 19 patients). Clinical evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS), 12-Item Short Form Health Survey 12 (SF-12) regarding its Physical and Mental Component Summary items. The radiographic evaluation considered anteroposterior and lateral ankle radiographs. Complications were also registered and classified as major or minor. The minimum follow-up was 2 years. RESULTS: The average AOFAS, VAS, and SF-12 scores improved significantly postoperatively (P < .001), without differences between groups. At final radiographic follow-up, the valgus alignment group did not show significant differences with the neutral alignment group regarding TTS, lateral distal tibial angle, or anterior distal tibial angle (P > .05). CONCLUSION: LTTAR in cases with valgus deformity achieved and maintained correction at short-term follow-up, as obtained in neutral alignment ankles. Clinical outcomes improved significantly regardless of preoperative valgus deformity. LEVEL OF EVIDENCE: Prognostic Level III, retrospective cohort study.

Joelho valgo em cães de pequeno porte - relato de dois casos / Valgus deformity of the stifle joint in small dogs-report of two cases

O joelho valgo é observado primariamente em cães de raças gigantes como resultado da disparidade do crescimento da porção lateral e medial da epífise distal do fêmur, apesar da porção proximal da tíbia poder estar envolvida. As formas de tratamento são: epifisiodese, transecção periosteal invertida em ôTö ou osteotomia corretiva. Descreve-se dois casos de joelho valgo em cães jovens de pequeno porte. À palpação observou-se crepitação e diferentes graus de luxação patelar. O exame radiográfico revelou desvio longitudinal da tíbia com moderado estreitamento do espaço intra-articular medial. O tratamento padrão para ambos os casos foi a ostectomia cuneiforme varizante, seguida de fixação com placa e parafusos. Após a cirurgia, observou-se deambulação normal com remissão dos sinais clínicos, apesar da manutenção da luxação patelar. O relato destes casos prende-se à raridade de tal condição ortopédica em cães de pequeno porte, atentando-se ao fato de que tal afecção pode ser confundida clinicamente com a luxação de patela, a qual não seria corretamente tratada com técnicas tradicionais para estabilização articular.