Radiologic Changes of Ankle Joint after Total Knee Arthroplasty

Lee, Jung Hee; Jeong, Bi O

doi:10.3113/fai.2012.1087

Cited by 69 publications

(97 citation statements)

References 15 publications

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“…This redistribution of pressure over a smaller surface of the talar dome could have long‐term implications for the biomechanics of the ankle. This is especially germane considering that previous studies have linked realignment procedures about the knee (both HTO and TKA) with the development and progression of ankle OA or ankle pain . It seems likely that the subtalar joint plays an important role in maintaining adequate alignment and force distribution .…”

Section: Discussionmentioning

confidence: 99%

“…A change in the ankle tilt after HTO was deemed as the most likely cause of pain due to possible changes in the contact area of the ankle joint and the patient was treated with a corrective supramalleolar osteotomy. Other studies have shown that total knee arthroplasty (TKA), in which lower limb alignment is also corrected, results in variations in hindfoot alignment . In a series of 142 TKA cases, Lee et al showed that 22% had newly developed or progressive ankle OA.…”

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confidence: 99%

“…In a series of 142 TKA cases, Lee et al showed that 22% had newly developed or progressive ankle OA. They correlated the incidence of ankle OA after TKA with increased talar tilt, which may lead to an altered contact surface area . Tallroth et al detected concomitant ankle OA in 29% of patients who were surgically treated for OA of the knee, with greater ankle tilt being associated with more degenerative changes in the ankle joint surface .…”

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confidence: 99%

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Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Suero

Sabbagh

Westphal

et al. 2015

Journal Orthopaedic Research

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High tibial osteotomy (HTO) is a commonly used surgical technique for treating moderate osteoarthritis (OA) of the medial compartment of the knee by shifting the center of force towards the lateral compartment. Previous studies have documented the effects of HTO on the biomechanics of the knee. However, the effects of the procedure on the contact pressures within the ankle joint have not been as well described. Seven cadavers underwent an HTO procedure with sequential 5˚valgus realignment of the leg up to 15˚of correction. An axial force of up to 550 N was applied and the intraarticular pressure was recorded. Minor valgus realignment of the proximal tibia does not significantly alter the biomechanics of the ankle. However, moderate-to-large changes in proximal tibial alignment result in significantly decreased tibiotalar contact surface area and in changes in intraarticular ankle pressures. These findings are clinically relevant, as they provide a biomechanical rationale for the diagnosis and treatment of ankle symptoms in the setting of lower limb malalignment or after alignment correction procedures. ß

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Suero

Sabbagh

Westphal

et al. 2015

Journal Orthopaedic Research

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“…We found that many patients complained of pain in the ankle after total knee arthroplasty, and we surmised that a change in the alignment of the lower extremity caused by a relatively large knee varus correction angle might be one of the reasons for the discomfort. Jung Hee Lee et al [3] reported that 35.2% of patients had radiographic change in ankle joint after conventional total knee arthroplasty (TKA), and this may be an early sign of ankle osteoarthritic change [3].…”

Section: Resultsmentioning

confidence: 99%

Computer-Assisted TKR Vs Conventional TKR: Post-Operative Ankle Radiographic Finding and Ankle Clinical Assessment

Khongphaophong¹

2016

MOJOR

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“…The postoperative knee joint obliquity can be compensated by the ankle joint [8,[15][16][17][18]. The capacity of compensation was suggested to be determined by the mobility of the subtalar joint [17,19], which differs by individual.…”

Section: Introductionmentioning

confidence: 99%

Knee ankle joint line angle: a critical value at 10。 for decompensated knee joint line obliquity in medial opening wedge osteotomy.

Tseng

Hsu

Wang

2020

Preprint

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Background: Medial opening wedge high tibial osteotomy (MOWHTO) changes the knee joint inclination in the coronal plane, which can be compensated by the ankle joint. Once there is a decompensated knee joint obliquity, it can induce excessive shear force on the articular cartilage. This study aimed to investigate the capacity of the compensation by analyzing the correlation of the knee-ankle joint line angle (KAJA) and the knee joint line obliquity (KJLO).Methods: The correlations between postoperative KJLO and body mass index (BMI), correction amount, KAJA, mechanical lateral distal femoral angle (mLDFA), preoperative medial proximal tibia angle (MPTA), ankle joint line obliquity (AJLO), KJLO and mechanical hip-knee-ankle angle (mHKA) were analyzed using Pearson correlation coefficient. The contribution of significant factors was further analyzed using multiple linear regression. The KJLO between ≦ 5。, 5。-10。And ≧ 10。KAJA groups were compared using Kruskal-Wallis test.Results: Postoperative KAJA and preoperative KJLO moderately correlated to postoperative KJLO. Preoperative MPTA, mHKA, AJLO weakly correlated to postoperative KJLO. After multiple linear regression, only postoperative KAJA, preoperative MPTA and mHKA still showed significant contribution, while preoperative KAJA made the greatest contribution. The KJLO was substantial higher in the ≧ 10。KAJA group with a high rate (68%) of high-degree KJLO.Conclusions: 10。postoperative KAJA is a critical value for decompensated KJLO. The results suggest us carefully assess the KAJA intraoperatively. Double osteotomy should be considered if ideal alignment cannot be achieved when the KAJA reach 10。.

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Radiologic Changes of Ankle Joint after Total Knee Arthroplasty

Cited by 69 publications

References 15 publications

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Computer-Assisted TKR Vs Conventional TKR: Post-Operative Ankle Radiographic Finding and Ankle Clinical Assessment

Knee ankle joint line angle: a critical value at 10。 for decompensated knee joint line obliquity in medial opening wedge osteotomy.

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