Influence of hindfoot alignment on postoperative lower limb alignment in medial opening wedge high tibial osteotomy

Evaluation of postoperative orientation of the knee and ankle joint after open wedge high tibial osteotomy

“…Subtalar compensation has been reported as a reason for the lateral inclination of the ankle joint to shift to a neutral alignment after surgery. 2 , 8 Previous reports have described that the preoperative varus deformity of the ankle is compensated by the valgus alignment of the subtalar joint, and that the postoperative changes to the ankle in the valgus direction is compensated by the varus alignment of the subtalar joint. 15 Changes in the deformity of the ankle joint due to varus knee OA is relatively mild and indicated for OWHTO, thereby enabling an easier subtalar compensation that results in many cases with good postoperative alignment of the ankle joint.…”

“…Miyazaki et al. 2 reported that a larger deviation of the forefoot alignment (TPI + hindfoot alignment) results in an increased likelihood of under-correction in postoperative lower limb alignment. Although only the TPI was considered in this study, no effect on postoperative alignment correction was observed as a result of preoperative TPI and pre-to post-operative changes in TPI.…”

“…However, not all correction angles affect the KJLO, and the compensation for the correction of the ankle joint and foot could potentially be at play. 8 Although previous reports have described changes to the TPI with respect to the floor after OWHTO, 2 , 3 , 12 , 13 few studies have reported on the relationship between the correction angle and severity of KJLO. The purpose of this study is to examine the correlation between the correction angle after OWHTO and the change in knee and ankle inclination angles with respect to the floor at our hospital.…”

“…Previous reports have suggested other important factors to consider for achieving an ideal correction for OWHTO, including the role of soft tissues around the knee joint such as the joint line convergence angle (JLCA), as well as the effect of the ankle joint and hindfoot alignment. 2 , 3 , 4 …”

Evaluation of the hindfoot alignment before and after total knee arthroplasty

“…8,14e18 A previous study used the hindfoot alignment angle (HAA) to evaluate SJ compensation and showed that lower limb alignment after OWHTO was undercorrected because of abnormal SJ compensation. 14 Thus, the SJ is an important factor in determining lower limb alignment. However, SJ compensation may be affected by the complicated structure of the joint, and the pathophysiology has not been clarified.…”