• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.8-15
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• 2018

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.119-123
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• 2011

This article has reviewed the alignment of the ankle and hindfoot in varus ankle osteoarthritis. The indication and surgical technique of the supramalleolar osteotomy has been reviewed. Alignment of tibial plafond and hindfoot is variable in early stages of ankle osteoarthritis. Supramalleolar osteotomy is indicated for the treatment of ankle osteoarthritis in patients with minimal talar tilt and neutral or varus heel alignment.

• Journal of Korean Foot and Ankle Society
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• v.21 no.4
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• pp.122-127
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• 2017

This paper reviews the indications and surgical technique of supramalleolar osteotomy as one of the treatments for moderate degenerative ankle osteoarthritis. Although it is technically demanding and requires extensive preoperative planning, supramalleolar osteotomy will be a good treatment option for moderate degenerative ankle osteoarthritis. The osteotomy is designed to shift the weight bearing axis to the lateral side of the ankle joint and unload the medial side of the joint. In our experience, a supramalleolar osteotomy is effective to the treatment of moderate ankle osteoarthritis with a small amount of preoperative talar tilt and varus or normal heel alignment.

• Journal of Korean Foot and Ankle Society
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• v.15 no.1
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• pp.27-31
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• 2011

Purpose: This study evaluated the efficacy of an intra-articular injection of sodium hyaluronate in the treatment of early stage osteoarthritis of the ankle. Materials and Methods: Early stage ankle osteoarthritis (Takakura stage I and II) patients who received hyaluronic acid injection therapy were retrospectively reviewed. Patients underwent intra-articular injections of 2 mL of sodium hyaluronate for 3 consecutive weeks. Clinical evaluation and Visual Analogue Scale (VAS) scoring were performed at every three months after treatment. Results: Total 27 patients were involved and mean age was 55 year old (range 33 to 77 years). There were 13 male and 14 female patients. Mean follow up duration was 13 month and. Pre-intra-articular VAS score was $8.9{\pm}0.7$ and three month follow up score was $3.8{\pm}2.8$. VAS score of last follow up was $3.2{\pm}3.4$. The effect of hyaluronic acid continued about one year when analyzed the VAS score change of the patients followed for more than one year. Patients' satisfaction was "very satisfied" in nine, "satisfied" in 12, "fair" in one, and "not satisfied" in five patients. Overall satisfaction rate was 82%. There were no ankle osteoarthritis stage changes in serial follow up radiograph. Conclusion: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular hyaluronate injection. Efficacy of Hyaluronate acid injection persisted more than 1 year in our study. Intra-articular hyaluronate injection to ankle osteoarthritis is safe and effective as knee joint and should be considered as a valid conservative treatment for ankle osteoarthritis.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.115-118
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• 2011

Treatment of osteoarthritis of the ankle joint is similar to that of any other large joint and includes conservative and surgical treatments. Surgical option in severe osteoarthritis is joint fusion or joint replacement, whereas conservative treatment is limited and includes mainly ankle supports, physical therapy, and oral medication. Hyaluronic acid was discovered in 1934 and now has been widely used in the knee and shoulder joints. We reviewed the articles about an intra-articular hyaluronic acid injection in the treatment of osteoarthritis of the ankle joint.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.71-77
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• 2022

Purpose: This study sought to investigate the appropriate indications for intra-articular injection of hyaluronic acid in ankle osteoarthritis, its efficacy at each stage of osteoarthritis and to compare the efficacy related differences at each stage. Materials and Methods: A retrospective study was conducted from January 2016 to September 2019 on 43 patients (50 cases) diagnosed with ankle arthritis and given intra-articular injection of hyaluronic acid. Patients were classified according to the modified Takakura ankle osteoarthritis stages. Stage 2 comprised 24 cases; stage 3A, 15 cases; stage 3B, 8 cases; and stage 4, 3 cases. The clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). The patients' satisfaction with the injection was evaluated at 1 year after injection. A radiographic evaluation was performed to gauge the progression of osteoarthritis before and after the injection. Results: The VAS, AOFAS score, and FAOS at 3 months and 1 year after injection showed statistically significant improvements compared to those before the injection. There was a significant difference in the VAS for each stage over time; however, this was not the case with the AOFAS score and the FAOS. A significant improvement of the VAS after injection was seen only in stage 3A when compared with the other stages. The overall satisfaction rate with the injection was 90%. There were no ankle osteoarthritic stage changes in the serial follow-up radiograph. Conclusion: Intra-articular injection of hyaluronic acid resulted in a significant clinical improvement up to 1 year after the injection. Therefore, the intra-articular injection of hyaluronic acid could be a treatment option for ankle osteoarthritis.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.28-33
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• 2013

Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.64-70
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• 1998

Primary osteoarthritis of the ankle without history of trauma is rare. We are reporting the use of a low tibial osteotomy on 2 ankles in one patient. The osteotomy is designed to correct the varus tilt and anterior opening of the distal tibial joint surface where it has been shown by weight-bearing radiographs. Follow-up at 8 months the result showed to be excellent, by Takakura's scoring system. We experienced that slight overcorrection of deformity by low tibial osteotomy is effective in treating intermediate-stage primary osteoarthritis of the ankle.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.13-17
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• 2001

Objectives: This study was done to determine the prevalence of radiographic ankle osteoarthritis (OA) in Korean women with clinical primary ankle OA. Methods: This analysis involved 160 Korean women who visited our out patient clinic due to ankle joint pain. Ankle AP and lateral weight-bearing radiographs were evaluated retrospectively to check whether they have radiographic OA or not. Radiographs were read for features of ankle OA using School classification. Demographic factors and radiographic findings in both radiographic ankle OA group and non-radiographic ankle OA group were analyzed by the student t-test, the chi square test and the Pearson's analysis. A p value <0.05 was considered significant. Results: The prevalence of radiographic ankle OA in Korean women is 18.2 % in patient between 18 and 39 years and is 55.6 % in patient over 40. There was significant difference between two groups with age (P<0.001) and relatively strong correlation between radiographic OA and age (r=0.474, P<0.001). Conclusion: These results show that the prevalence of Korean women with radiographic changes of ankle OA was 45 % and there was relatively strong correlation between age and radiographic ankle OA.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.141-146
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• 2014

Low tibial osteotomy is an extra-articular procedure that realigns the mechanical axis, restoring ankle function. It is also an alternative surgical procedure to manage early osteoarthritis of the ankle joint. This can mainly address ankle varus/valgus, as well as procurvatum/ recurvatum, internal/external rotation, equinus, calcaneus, and limb length discrepancy. The authors describe the history, mechanism, indications, and limitations of low tibial osteotomy focused on osteoarthritis of the ankle with varus malalignment reviewing several articles published thus far.