Supracondylar rotation osteotomy of the femur influences the coronal alignment of the ankle

Abstract Purpose Osteotomies represent well‐established treatment‐options for the redistribution of loads and forces within and around the knee‐joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal‐femoral‐rotation‐osteotomy on the coronal alignment of the ankle. It was hypothesized that supracondylar‐external‐rotation‐osteotomy of the distal femur leads to a change in the coronal orientation of the ankle joint. Methods Long‐leg standing radiographs and CT‐based torsional measurements of 27 patients undergoing supracondylar‐rotational‐osteotomy of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy‐site. The hip‐knee‐ankle‐angle (HKA), the mechanical‐lateral‐distal‐femur‐angle (mLDFA), and Tibia‐Plafond‐Horizontal‐Orientation‐Angle (TPHA) around the ankle were measured. Comparison between means was performed using the Wilcoxon‐Mann–Whitney test. Results Twenty‐seven patients with high femoral antetorsion (31.3° ± 4.0°) underwent supracondylar‐external‐rotation‐osteotomy. The osteotomy led to a reduced antetorsion (17.4 ± 5.1; p