Ankle Distraction and Supramalleolar Osteotomy for Arthrosis and Deformity

Ankle distraction arthroplasty and supramalleolar osteotomy have been independently shown to improve pain and function for patients with ankle arthritis. When combined, these techniques may be synergistic, providing further improved results. Ankle distraction is utilized to fill areas of eburnated bone with a layer of cartilage-like matrix and to soften sclerotic subchondral bone. When deformity is present, the high joint contact pressure is concentrated on a small section of the joint surface. There is concern that a successful joint distraction procedure in this environment would quickly wear out, with the new cartilage breaking down and reverting to its pre-procedure status. By combining joint re-alignment with distraction we provide a more even distribution of pressure over a greater area which may help preserve the new cartilage-like matrix and provide long-lasting relief.