Changes in Hindfoot Alignment After High or Low Tibial Osteotomy

Choi, Jun Young; Song, S.J.; Kim, Sung Jung; Kim, Sang Hee; Park, Ji Soo; Suh, Jin Soo

doi:10.1177/1071100718773767

Cited by 37 publications

(42 citation statements)

References 24 publications

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“…Surgical procedures such as TKA or HTO for the varus knee OA could also improve the subtalar compensatory malalignment (Table 1) [7, 8, 11, 13, 14, 16]. In particular, greater improvements of hindfoot valgus occurred in patients with a severe varus deformity of the knee joint [14], and the variation of correction of varus knee alignment was significantly correlated with that of valgus subtalar alignment after TKA [7].…”

Section: Discussionmentioning

confidence: 99%

“…The influence of surgery for the ankle deformity to the subtalar joint was only evaluated in one study (Table 1) [16] and was quite unclear. They showed that the hindfoot alignment was varus in patients with advanced ankle OA and changed to valgus after LTO.…”

Section: Discussionmentioning

confidence: 99%

“…The change of the subtalar joint alignment after tibial osteotomy for knee malalignment was also assessed. Choi et al [16] evaluated the hindfoot alignment after high tibial osteotomy. They found that the preoperative degree of hindfoot valgus deviation (7.8° valgus) decreased progressively 3 months, 6 months, and 12 months after HTO (4.0°, 3.4°, and 2.3° valgus, respectively).…”

Section: The Subtalar Joint Alignment After Surgery For the Knee Mmentioning

confidence: 99%

“…There is only one report by Choi et al [16] which evaluated the hindfoot alignment after surgery for ankle OA. They evaluated the hindfoot alignment after low tibial osteotomy (LTO) [32] for ankle OA.…”

Section: The Subtalar Joint Alignment After Surgery For the Ankle mentioning

confidence: 99%

“…Each joint of the lower extremity compensates the malalignment caused by deformities of the other joints [10, 11, 20]. In particular, recent studies have discussed the compensatory function of the subtalar joint [7, 13, 19]: several reports show that the subtalar joint compensates for the deformities of the knee and ankle joints [10, 12, 17, 18, 20], and the subtalar joint alignment which was 2°-6° valgus in healthy legs [21, 22] changed after surgery to correct these deformities [7, 14, 16]. When surgery for knee or ankle deformity is needed, it is helpful for surgical planning to understand the mechanism of subtalar joint compensation and how the subtalar joint alignment changes after surgery.…”

Section: Introductionmentioning

confidence: 99%

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Compensatory Function of the Subtalar Joint for Lower Extremity Malalignment

Yoshimoto¹,

Noguchi²,

Yamada³

et al. 2019

Advances in Orthopedics

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It is important to evaluate the subtalar joint and hip-knee-ankle alignment to understand lower extremity alignment. In this review, we focused on the compensatory changes in the subtalar joint alignment for the deformity of the knee and ankle joint, reviewing previous research. The subtalar joint alignment was compensatory valgus in patients with varus knee and ankle deformity, whereas it was uncertain whether the subtalar joint alignment was compensatory varus in patients with valgus knee and ankle deformity. The subtalar joint valgus alignment improved after total knee arthroplasty or high tibial osteotomy for varus knee deformity, even if the deformity was severe. In contrast, whether the subtalar joint alignment changed after the surgery for ankle or valgus knee deformity has not been considered. Further research on the compensatory function of the subtalar joint is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: The Subtalar Joint Alignment After Surgery For the Knee Mmentioning

confidence: 99%

Section: The Subtalar Joint Alignment After Surgery For the Ankle mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Compensatory Function of the Subtalar Joint for Lower Extremity Malalignment

Yoshimoto¹,

Noguchi²,

Yamada³

et al. 2019

Advances in Orthopedics

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Medial opening low tibial osteotomy shifts the load laterally not only at the ankle joint but also at the knee joint

Wanezaki,

Kurokawa,

Ueno

et al. 2024

J. exp. orthop.

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PurposeThe purpose of this study was to determine the effects of medial opening low tibial osteotomy (LTO) on lower limb alignment, including the knee joint, 1 year after low tibial osteotomy.MethodsThis study included 20 legs of 20 patients (mean age, 66.8 ± 5.4 years) who underwent LTO for medial ankle osteoarthritis and evaluated the changes in the hip–knee–ankle angle (HKA), percentage hip‐to‐ankle line (%HA), percentage hip‐to‐calcaneal line (%HC), medial proximal tibial angle (MPTA), knee joint line convergence angle (K‐JLCA), tibio‐calcaneal angle (TCA), tibial anterior surface angle (TAS), tibio‐plafond inclination (TPI), talar inclination (TI), ankle joint line convergence angle (A‐JLCA), mechanical ankle joint axis point (MAJAP) on radiographs and the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale before and 1 year after low tibial osteotomy.ResultsThe mean preoperative/postoperative measured values showed the following: HKA (degrees) of 1.0 ± 3.7/−0.8 ± 3.7; %HC of 38.8 ± 10.0/53.8 ± 16.1; MPTA (degrees) of 85.6 ± 2.4/87.6 ± 2.1; and A‐JLCA (degrees) of 4.2 ± 2.9/1.1 ± 2.3 respectively. Including other measurements, a significant increase in the %HA, %HC, MPTA, TCA, TAS, MAJAP and JSSF ankle/hindfoot scale was observed postoperatively, whereas a significant decrease in the HKA, TPA, TI and A‐JLCA was observed postoperatively (p < 0.05). With the numbers available, no significant differences were observed between the preoperative and postoperative values of K‐JLCA (n.s.).ConclusionAfter LTO, the entire lower limb alignment became valgus, and the loading points of the knee and ankle joints shifted laterally. These changes must be considered when performing LTO, especially in patients with lateral knee OA.Level of EvidenceⅣ

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Correction of excessive intraarticular varus deformities in total knee arthroplasty is associated with deteriorated postoperative ankle function

Graef

Falk

Tsitsilonis

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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PurposeThe aim of this study was to demonstrate, whether the degree of limb alignment correction in varus knee osteoarthritis correlated with an increase in ankle symptoms and to define a cut‐off value concerning the degree of correction above which to expect ankle problems. MethodsNinety‐nine consecutive patients with preoperative intraarticular varus knee deformities who underwent total knee arthroplasty were retrospectively analyzed. Patients were examined clinically (Knee Society Score, Forgotten Joint Score, Foot Function Index, Range of Motion of the knee and ankle joint, pain scales) as well as radiologically. The mean follow‐up time was 57 months. ResultsThe degree of operative limb alignment correction strongly correlated with the Foot Function Index (R = 0.91, p < 0.05). Given this, higher degrees of knee malalignment corrections were associated with worse postoperative outcomes in the knee and ankle joint—despite postoperative improved joint line orientations. Subsequently, a cut‐off value for arthritic varus deformities (14.5°) could be calculated, above which the prevalence of ankle symptoms increased manifold [OR = 15.6 (3.2–77.2 95% CI p < 0.05)]. Furthermore, ROM restrictions in the subtalar joint were associated with a worse outcome in the ankle joint. ConclusionsWhen correcting excessive intraarticular varus knee osteoarthritis, surgeons have to be aware of possible postoperative ankle symptoms and should consider ankle deformities or decreased subtalar ROM before operative procedures. Level of evidenceIII.

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Changes in Hindfoot Alignment After High or Low Tibial Osteotomy

Abstract: Level III, comparative series.

Cited by 37 publications

References 24 publications

Compensatory Function of the Subtalar Joint for Lower Extremity Malalignment

Compensatory Function of the Subtalar Joint for Lower Extremity Malalignment

Medial opening low tibial osteotomy shifts the load laterally not only at the ankle joint but also at the knee joint

Correction of excessive intraarticular varus deformities in total knee arthroplasty is associated with deteriorated postoperative ankle function

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