Amelioration in Ankle Pain and Improvement in Function After Total Knee Arthroplasty for Ipsilateral Knee and Ankle Osteoarthritis: A Report of Two Cases

Kunugiza, Yasuo; Tomita, Tadanori; Hirao, Makoto; Hamada, Masayuki; Hosono, Noboru

doi:10.1016/j.artd.2020.09.005

Cited by 5 publications

(6 citation statements)

References 20 publications

(25 reference statements)

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“…In this system, knee varus is associated with the development/progression of ankle osteoarthritis [ 22 ]. Furthermore, realignment of the knee joint has a potential to change the talar tilt angle, subsequently ameliorate ankle pain, and improve foot/ankle function [ 23 ], suggesting that knee alignment affects the loading pattern on the ankle joint. Thus, to check knee alignment, the hip–knee–ankle angle (HKA) [ 23 ] was also measured.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, realignment of the knee joint has a potential to change the talar tilt angle, subsequently ameliorate ankle pain, and improve foot/ankle function [ 23 ], suggesting that knee alignment affects the loading pattern on the ankle joint. Thus, to check knee alignment, the hip–knee–ankle angle (HKA) [ 23 ] was also measured. A positive HKA angle indicates varus alignment of the knee joint.…”

Section: Methodsmentioning

confidence: 99%

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Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

Noguchi

Hirao

Tsuji

et al. 2021

IJERPH

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Foot/ankle problems remain important issues in rheumatoid arthritis (RA) patients. Although forefoot deformity generally takes a major place in surgical treatment, concomitant mid-hindfoot deformity is also commonly seen. In this situation, it can be easy to overlook that mid-hindfoot deformity can also induce or exacerbate clinical problems behind the forefoot events. Thus, the relationship between mid-hindfoot deformity/destruction and physical activity/ADL was investigated. Radiographic findings of 101 lower limbs (59 patients) were retrospectively evaluated. Alignment parameters in the lower extremity and joint destruction grade (Larsen grade) were measured. The timed-up-and-go (TUG) test, modified health assessment questionnaire (mHAQ), pain, self-reported scores for the foot and ankle (SAFE-Q), and RA disease activity were investigated to assess clinical status. The relationships among these parameters were evaluated. Subtalar joint destruction was correlated with TUG time (r = 0.329), mHAQ score (r = 0.338), and SAFE-Q: social functioning (r = 0.332). TUG time was correlated with the HKA (r = −0.527), talo-1st metatarsal angle (r = 0.64), calcaneal pitch angle (r = −0.433), M1-M5A (r = −0.345), and M2-M5A (r = −0.475). On multivariable linear regression analysis, TUG time had a relatively strong correlation with the talo-1st metatarsal angle (β = 0.452), and was negatively correlated with calcaneal pitch angle (β = −0.326). Ankle joint destruction was also correlated with TUG time (β = 0.214). Development of structural problems or conditions in mid-hindfoot, especially flatfoot deformity, were related with decreased physical activity in RA patients. Wearing an insole (arch support) as a preventative measure and short foot exercise should be considered from the early phase of deformity/destruction in the mid-hindfoot in the management of RA.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

Noguchi

Hirao

Tsuji

et al. 2021

IJERPH

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“…In this situation, varus knee is associated with development/progression of ankle osteoarthritis [8]. Furthermore, re-alignment of the knee joint has the potential to change the talar tilt angle, subsequently ameliorate ankle pain, and improve foot/ankle function [9], suggesting that knee alignment influences the loading pattern on the ankle joint. Thus, to check knee alignment, hip-knee-ankle (HKA) angle [9] was also measured.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

“…Furthermore, re-alignment of the knee joint has the potential to change the talar tilt angle, subsequently ameliorate ankle pain, and improve foot/ankle function [9], suggesting that knee alignment influences the loading pattern on the ankle joint. Thus, to check knee alignment, hip-knee-ankle (HKA) angle [9] was also measured. A positive HKA angle indicates varus alignment of the knee joint.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

Characteristics of Intermetatarsal Angle Between the Second and Fifth Metatarsals (M2-M5A) in the Rheumatoid Foot

Noguchi¹,

Hirao²,

Tsuji³

et al. 2022

Cureus

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Background: Increasing of intermetatarsal angle between the first and second metatarsals (M1-M2A) has been reported as a risk factor for recurrence of hallux valgus (HV) deformity, on the other hand, increasing of intermetatarsal angle between the second and fifth metatarsals (M2-M5A) has been reported as a risk factor for resubluxation of the metatarsophalangeal (MTP) joint of the lesser toe after rheumatoid forefoot surgery. In this study, parameters related to increasing M2-M5A were investigated, as compared with M1-M2A and M1-M5A.Methods: Radiographic parameters including M1-M2A, M1-M5A, and M2-M5A were retrospectively evaluated for 119 lower limbs from 68 patients with rheumatoid arthritis (RA). To clarify the clinical importance of these intermetatarsal angles, relationships with results from the timed up-and-go (TUG) test were also investigated.Results: M1-M5A showed no correlation with mid-hind foot parameters, whereas M1-M2A and M2-M5A correlated with valgus/varus parameters. An increased M1-M2A was associated with lateral shift of the loading axis in the tibial plafond, whereas an increased M2-M5A was associated with medial shift, but M1-M5A showed no associations. M2-M5A/M1-M2A was significantly lower (1.7) in the normal TUG group than in the delayed TUG group (2.8) (p=0.045).Conclusions: Different patterns of spread are seen for the forefoot. One has a predominantly increased M1-M2A with lateral shift of the loading point in the tibial plafond, whereas the other has a predominantly increased M2-M5A with medial shift of the loading point in the tibial plafond. M2-M5A also should be calculated, and M2-M5A/M1-M2A might be meaningful in understanding physical mobility in RA patients.Categories: Orthopedics, Rheumatology, Podiatry Keywords: timed up-and-go (tug) tests, loading axis, intermetatarsal angle between 1st and 2nd metatarsals (m1-m2a), rheumatoid arthritis (ra), intermetatarsal angle between 2nd and 5th metatarsals (m2-m5a)

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“…Some reaction to changes in loading axis/transmission might occur throughout the entire lower extremity after correction in these joints. In such situations, amelioration of ankle pain and improvement in alignment and function were reported after knee correction by total knee arthroplasty (TKA) for ipsilateral knee and ankle OA 3 . By contrast, the impact of correction surgery in the ankle/hindfoot on pain or function in more proximal joints such as the knee remains unclear.…”

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confidence: 99%

Improvement of Knee Alignment and Function After Corrective Surgery for Hindfoot Deformity

Etani

Hirao

Ebina

et al. 2022

JBJS Case Connector

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Case: Marked varus or valgus hindfoot deformities in 3 patients with ankle osteoarthritis or rheumatoid arthritis were treated by corrective surgery using total ankle arthroplasty or distal tibia oblique osteotomy. All cases achieved not only sufficient correction and satisfactory clinical/radiographic hindfoot improvement but also improvements in both knee alignment and function. Conclusion: Corrective surgery for hindfoot deformity can potentially change or improve ipsilateral knee alignment and function, representing an unexpected benefit of hindfoot realignment.

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Amelioration in Ankle Pain and Improvement in Function After Total Knee Arthroplasty for Ipsilateral Knee and Ankle Osteoarthritis: A Report of Two Cases

Cited by 5 publications

References 20 publications

Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

Characteristics of Intermetatarsal Angle Between the Second and Fifth Metatarsals (M2-M5A) in the Rheumatoid Foot

Improvement of Knee Alignment and Function After Corrective Surgery for Hindfoot Deformity

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