Management of varus ankle osteoarthritis with joint-preserving osteotomy.

The goal of osteotomy in the treatment of varus ankle arthritis is to shift the forces imparted to the ankle to a portion of the joint that is not involved in the degenerative process. The redistribution of loads and stresses seen by the tibiotalar joint can be approached either above or below the ankle with an osteotomy of the tibia or calcaneus. Evaluation of the deformity as being subtalar, supramalleolar, or a combination allows the surgeon to best address the increased joint stresses, thereby reducing the risk of failure of the osteotomy.