Changes in hindfoot alignment after total knee arthroplasty in knee osteoarthritic patients with varus deformity

Cho, Woo-Shin; Cho, Hun-Sik; Byun, Seong‐Eun

doi:10.1007/s00167-016-4278-8

Cited by 34 publications

(64 citation statements)

References 29 publications

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“…12 However, the evaluation of ankle joints after TKA has been examined only after MATKA. 19,22 Our results indicate that both MATKA and KATKA decrease the ankle joint compensatory change of alignment as reported in previous studies. Adding to what is known about decreased compensation, the present study indicates that KATKA restores ankle joint alignment closer to that of a control group compared with MATKA.…”

Section: Discussionsupporting

confidence: 89%

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

et al. 2019

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Mechanically aligned total knee arthroplasty (MATKA) aims to make alignment of the hip, knee, and ankle straight unexceptionally. However, emerging evidence suggests that unexceptional straightening the mechanical axis of the lower limb may lead to clinical and radiological problems of the ankle joint. By contrast, kinematically aligned total knee arthroplasty (KATKA) strives to restore the articular surface of the prearthritic knee. In this study, we examined results from KATKA and MATKA to determine which surgery restores the ankle joint orientation closer to the native ankle joint in bipedal stance and hypothesized that KATKA, rather than MATKA, would be more effective. Data from long-leg standing radiographs of 60 healthy adults (control group, n = 120 knees), patients who underwent MATKA (n = 90 knees), and patients who underwent KATKA (n = 90 knees) were retrospectively reviewed. The hip–knee–ankle angle, orientation of the tibial plafond and the talar dome relative to the ground (G-plafond and G-talus, respectively), and orientation of the plafond relative to the mechanical axis of the limb (M-plafond and M-talus, respectively) were measured and analyzed for comparison. Results show that bipedal stance alignment in patients who underwent KATKA (G-plafond: −0.65 ± 3.03 and G-talus: −1.72 ± 4.02) were not significantly different to native ankle joint alignment indicated by the control group. Compared with the native ankle joint measured in the control group (G-plafond: −0.76 ± 2.69 and G-talus: −1.30 ± 3.25), the tibial plafond and talar dome significantly tilted laterally relative to the ground in ankle joints after MATKA (G-plafond: −2.32 ± 3.30 and G-talus: −2.97 ± 3.98, p = 0.001 and p = 0.004, respectively). Thus, postoperative ankle joint line orientation after KATKA was horizontal to the floor and closer to that of native ankle joints than those after MATKA. The level of evidence is Level III.

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Section: Discussionsupporting

confidence: 89%

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

et al. 2019

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“…In patients with osteoarthritis, the varus alignment in the knee joint is associated with the valgus alignment in the rare foot and the valgus alignment in the knee joint is associated with the varus alignment in the rare foot (16,17). The deformity in the rear foot has been reported to be improved following TKA surgery in some studies (9,10,16,18). However, there are very few studies evaluating the changes occurring in the pressure and strength of the sole following TKA (19).…”

Section: Discussionmentioning

confidence: 99%

“…However, there are very few studies evaluating the changes occurring in the pressure and strength of the sole following TKA (19). It is reported in the literature that the knee arthroplasty surgeons are concerned that the presence of a noteworthy foot or ankle joint deformity might result in an abnormal load on the knee prosthesis and this in turn may cause early mechanical problems in the prosthesis (10). In a study by Voronov et al (20), a minimal change was found in the load on the foot following correction of the knee deformity by TKA and this condition was reported as the compliance ability of the subtalar joint complex to the load changes.…”

Section: Discussionmentioning

confidence: 99%

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Total Diz Artroplastisi Sonrası Erken Dönemde Plantar Basınç Dağılımı Nasıl Değişir? Pilot Çalışma

Arık

Aras

Akkan

et al. 2018

Osmangazi̇ Journal of Medicine

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To evaluate how the static and dynamic plantar overload distribution patterns change following total knee arthroplasty (TKA) surgery using a pressure platform. Ten patients who met the inclusion criteria were included (mean age 68.5±7.9 years). Evaluations were performed prior to the surgery and on the 15th day after the surgery. Static balance parameters (anterior-posterior and total load distribution of the foot, ratio of weight bearing of the right and left foot, elliptic area of the pressure center and oscillation speed) were measured and recorded by Zebris™ FDM-2 (Zebris® Medical GmbH, Germany) device. Maximum strength produced in the posterior foot during walking, time percent of the walking cycle produced by this strength and middle foot maximum pressure values were found to be significantly decreased (p<0,05). Rotation degrees of the foot were found to be decreased in the patients, though not statistically significant. No significant differences were found in the total weight load on the foot, elliptic area, center of pressure (COP), line length and mean COP rate during static standing between the pre-surgical and postsurgical measurement results (p>0,05). Weight load measurement values on the forefoot of the opere side during standing were found to be significantly increased following surgery, while the weight load on the rear foot was found to be significantly decreased (p<0,05). The weight load on the rear foot and forefoot upon static stance was decreased and increased, respectively 15 days after the surgery in patients who underwent TKA surgery. The evaluations using force platform before and after surgery may be useful for orthopedic surgeons because TKA surgery used to correct knee alignment also affect loading parameters in early period.

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“… 9 In addition, KOA individuals with varus alignment also demonstrated changes in foot kinematics, such as greater rearfoot valgus. 10 All these findings are indicative of decreased foot mobility 7 and can be attributed to a reduction in the compensatory capacity of the foot-ankle joint complex in response to varus alignment. 8 11 Thus, although still inconclusive, there is some evidence on the mechanisms by which kinematic changes in the feet influence pain and knee cartilage degradation.…”

Section: Introductionmentioning

confidence: 99%

Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial

Dantas

Sacco²,

Santos

et al. 2020

BMJ Open

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IntroductionStudies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has shown that strengthening the foot-ankle muscles improved function in diabetic patients and reduced patellofemoral pain. The aim of this paper is to investigate whether an 8-week therapeutic foot-ankle exercise programme improves pain, functionality, foot strength, foot kinematics and knee joint overload during gait, and decreases medication intake in individuals with KOA.Methods and analysisThis two-arm, prospectively registered, randomised controlled trial with blinded assessors will involve 88 patients with medial tibiofemoral osteoarthritis. Subjects will be randomly allocated to a control group that will receive no specific foot intervention and will follow treatment recommended by the medical team; or an intervention group that will undergo an 8-week physiotherapist-supervised strengthening programme for extrinsic and intrinsic foot muscles, three times a week. The primary outcome will be the pain domain of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The secondary outcomes include WOMAC stiffness and function domains, total WOMAC score, physical function, foot muscle isometric strength, foot kinematics and knee kinetics during gait, and medication intake. Data will be analysed on intention-to-treat principles and a per protocol basis.Ethics and disseminationInvestigators and sponsors will communicate trial results to participants and healthcare professionals through scientific databases and social media. In addition, findings will be reported in peer-review publications, and at national and international conference presentations. Ethics approval: Ethics Committee of the Universidade Federal de São Carlos, São Carlos, SP, Brazil (N° 3.488.466).Trial registration numberNCT04154059.

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Changes in hindfoot alignment after total knee arthroplasty in knee osteoarthritic patients with varus deformity

Abstract: Prospective cohort study, Level II.

Cited by 34 publications

References 29 publications

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

Kinematically Aligned TKA Aligns the Ankle Joint Line Closer to Those of the Native Ankle than Mechanically Aligned TKA in Bipedal Stance

Total Diz Artroplastisi Sonrası Erken Dönemde Plantar Basınç Dağılımı Nasıl Değişir? Pilot Çalışma

Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial

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