ArticleOrthopaedic journal of sports medicine2023
The Unloading Effect of Supramalleolar Versus Sliding Calcaneal Osteotomy for Treatment of Osteochondral Lesions of the Medial Talus: A Biomechanical Study.
Article in Orthopaedic journal of sports medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 4 citations in OpenAlex.
- Does lateral column lengthening reach the ankle? Lateral calcaneal lengthening for flatfoot and medial talar dome osteochondral lesions: A weight-bearing CT 3D modelling analysis.Journal of experimental orthopaedics · 2026Article
- Subchondral bone conditions influence pain in patients with osteochondral lesion of the talus.Archives of orthopaedic and trauma surgery · 2025Article
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Authors and funding
8 authors at 1 institution in 1 country.
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Abstract
Background: In patients with osteochondral lesion, defects of the medial talus, or failed cartilage surgery, a periarticular osteotomy can unload the medial compartment. Purpose: To compare the effects of supramalleolar osteotomy (SMOT) versus sliding calcaneal osteotomy (SCO) for pressure redistribution and unloading of the medial ankle joint in normal, varus-aligned, and valgus-aligned distal tibiae. Study Design: Controlled laboratory study. Methods: Included were 8 cadaveric lower legs with verified neutral ankle alignment (lateral distal tibial angle [LDTA] = 0°) and hindfoot valgus within normal range (0°-10°). SMOT was performed to modify LDTA between 5° valgus, neutral, and 5° varus. In addition, a 10-mm lateral SCO was performed and tested in each position in random order. Axial loading (700 N) of the tibia was applied with the foot in neutral alignment in a customized testing frame. Pressure distribution in the ankle joint and subtalar joint, center of force, and contact area were recorded using high-resolution Tekscan pressure sensors. Results: At neutral tibial alignment, SCO unloaded the medial joint by a mean of 10% ± 10% or 66 ± 51 N ( Conclusion: SCO reliably unloaded the medial compartment of the ankle joint for a neutral tibial axis. Changes in the LDTA by SMOT did not positively affect load distribution, especially in varus alignment. The subtalar joint was affected by SCO and SMOT in opposite ways, which should be considered in the treatment algorithm. Clinical Relevance: SCO may be considered a reliable option for beneficial load-shifting in ankles with neutral alignment or 5° varus malalignment.
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