{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:30Z","timestamp":1787755590118,"version":"build-2784847793"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,12,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A preoperative severe coronal plane deformity of &gt;20\u00b0 has been considered a contraindication for total ankle arthroplasty. We aimed to evaluate whether outcomes of total ankle arthroplasty in ankles with severe coronal plane deformity (20\u00b0 to 35\u00b0 of varus or valgus) are comparable with those with moderate deformity (5\u00b0 to 15\u00b0 of varus or valgus).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 148 consecutive ankles (142 patients) that underwent primary total ankle arthroplasty using the HINTEGRA prosthesis were included. The overall mean follow-up duration was 74 months (range, 24 to 160 months). We divided all patients into 2 groups according to the preoperative coronal plane tibiotalar angle: the severe group (36 patients, 41 ankles) and the moderate group (106 patients, 107 ankles). Clinical and radiographic outcomes were analyzed for intergroup differences, and multivariable regression was used to adjust for baseline characteristics. Patients in each group showed similar characteristics in mean age, sex, mean body mass index, and median follow-up duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At a mean follow-up of 74 months, we found no significant intergroup difference in the Ankle Osteoarthritis Scale pain and disability score, American Orthopaedic Foot &amp; Ankle Society ankle-hindfoot score, Short Form-36 Physical Component Summary score, visual analog scale pain score, or ankle range of motion (p &gt; 0.05). However, the final tibiotalar angle, talar tilt angle, and number of outliers were greater in the severe group (p &lt; 0.05). Complication rates did not show a significant difference between the 2 groups (p &gt; 0.05). The overall survival probability of the implant was 91.3% (92.3% in the severe group and 90.7% in the moderate group) (p = 0.354).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Total ankle arthroplasty in ankles with preoperative severe coronal plane deformity showed satisfactory and comparable clinical outcomes without increasing complication rates relative to those with moderate deformity in the intermediate-term follow-up. Our results suggested that total ankle arthroplasty may be considered in ankles with deformity of &gt;20\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.00416","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T14:31:42Z","timestamp":1570631502000},"page":"2203-2211","source":"Crossref","is-referenced-by-count":52,"title":["Outcomes of Total Ankle Arthroplasty in Ankles with &gt;20\u00b0 of Coronal Plane Deformity"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9155-6498","authenticated-orcid":false,"given":"Gun-Woo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3808-2649","authenticated-orcid":false,"given":"Keun-Bae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,10,9]]},"reference":[{"issue":"5","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1302\/0301-620X.98B5.36887","article-title":"Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes","volume":"98-B","author":"Pedowitz","year":"2016","journal-title":"Bone Joint J."},{"issue":"24","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.2106\/JBJS.L.00465","article-title":"Ankle arthroplasty and ankle arthrodesis: gait analysis compared with normal controls","volume":"95","author":"Singer","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.2106\/00004623-200710000-00007","article-title":"Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty","volume":"89","author":"SooHoo","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1177\/1071100717723130","article-title":"Hindfoot arthritis progression and arthrodesis risk after total ankle replacement","volume":"38","author":"Dekker","year":"2017","journal-title":"Foot Ankle Int."},{"issue":"21","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.2106\/JBJS.16.01471","article-title":"Comparison of treatment outcomes of arthrodesis and two generations of ankle replacement implants","volume":"99","author":"Benich","year":"2017","journal-title":"J Bone Joint Surg Am."},{"issue":"9","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1177\/1071100718776021","article-title":"Frequency and impact of adverse events in patients undergoing surgery for end-stage ankle arthritis","volume":"39","author":"Norvell","year":"2018","journal-title":"Foot Ankle Int."},{"issue":"1","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2106\/JBJS.J.01613","article-title":"Intermediate to long-term outcomes of the STAR total ankle replacement: the patient perspective","volume":"94","author":"Nunley","year":"2012","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"S473","DOI":"10.3113\/FAI.2011.0473","article-title":"STAR\u2122 ankle: long-term results","volume":"32","author":"Mann","year":"2011","journal-title":"Foot Ankle Int."},{"issue":"9","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.2106\/00004623-200709000-00002","article-title":"Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. 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