Effect of total ankle replacement on the 3-dimensional subtalar joint alignment in varus ankle osteoarthritis

Background: Varus ankle osteoarthritis (OA) is typically associated with peritalar instability, which may result in altered subtalar joint position. This study aimed to determine the extent to which total ankle replacement (TAR) in varus ankle OA can restore the subtalar alignment.Methods: Fourteen patients (15 ankles, mean age 61 & PLUSMN; 6 years) who underwent TAR for varus ankle OA were analyzed using semi-automated measurements based on weight-bearing computed tomography. Twenty healthy individuals served as a control group. Results: All angles improved between preoperative and a minimum of 1 year (mean 2.1 years) postoperative and were statistically significant in 6 out of 8 angles (P < 0.05).Conclusions: Our findings indicate that talus repositioning after TAR restores the subtalar joint alignment which may improve hindfoot biomechanics. Future studies are required to implement these findings for TAR in presence of hindfoot deformity.Level of evidence: IV.& COPY; 2023 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.