Radiologic Factors Affecting Ankle Pain Before and After Total Knee Arthroplasty for the Varus Osteoarthritic Knee

Kim, Chang-Wan; Gwak, Heui-Chul; Kim, Jung-Han; Lee, Chang-Rack; Kim, Jeon-Gyo; Oh, Minkyung; Park, Ji-Hwan

doi:10.1053/j.jfas.2018.02.002

Cited by 29 publications

(58 citation statements)

References 11 publications

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“…Some of these patients have preexisting ankle OA [3][4][5][6]. Ankle pain following TKA is very troublesome and is associated with poorer clinical outcomes [3,5,7]. Therefore, to implement TKA in patients with both knee and ankle problems, one must consider possible postoperative changes in ankle alignment in the context of preventing ankle symptom exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Poor Correction Capacity of Preexisting Ankle Valgus Deformity after Total Knee Arthroplasty

Shih

Liao

et al. 2021

JCM

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This study investigated the differences in ankle alignment changes after TKA in patients with varying preexisting ankle deformities. We retrospectively examined 90 knees with osteoarthritis and varus deformity in 78 patients who underwent TKA. Preoperative and postoperative radiographic parameters were analyzed. According to their preexisting ankle deformity, patients were assigned to the valgus or varus group. Overall, 14 (15.6%) cases were of preoperative valgus ankle deformity; the remainder were of preoperative varus ankle deformity. Hip–knee–ankle angle (HKA), tibial plafond–ground angle (PGA), and talus–ground angle (TGA) all exhibited significant correction in both groups; however, tibial plafond–talus angle (PTA) and superior space of ankle joint (SS) only changed in the varus group. The median PTA and SS significantly decreased from 1.2° to 0.3° (p < 0.001) and increased from 2.5 to 2.6 mm (p = 0.013), respectively. Notably, ∆PTA positively correlated with ∆HKA in the varus group (r = 0.247, p = 0.032) but not in the valgus group. Between-group differences in postoperative PTA (p < 0.001) and ∆PTA (p < 0.001) were significant. The degree of ankle alignment correction after TKA differed between patients with preexisting varus and valgus ankle deformities. TKA could not effectively correct the preexisting ankle valgus malalignment.

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Section: Introductionmentioning

confidence: 99%

Poor Correction Capacity of Preexisting Ankle Valgus Deformity after Total Knee Arthroplasty

Shih

Liao

et al. 2021

JCM

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show abstract

“…Alignment changing of joint may be one of culprits for this problem. Previous studies confirmed that after we restored knee alignment, ankle and foot alignment were affected, too [2][3][4] . Moreover, Kim reported that changing of ankle joint alignment can aggravate pain in patients underwent TKA 3 .…”

Section: Discussionmentioning

confidence: 52%

“…The result of this study shows that no matter what method we used to cut tibia, it always makes ankle joint involved. Same as previous studies of Kim 3 and Chompoosang 4 . Difference between group was not statistical significance.…”

Section: Discussionmentioning

confidence: 73%

“…Some surgeons suspect about alignment changing may play a role in this problem. After correct deformity with conventional tibial cut, not only knee joint affected in changing of alignment, but also other joints involved [2][3][4] . Ankle joint is one of them.…”

Section: Introductionmentioning

confidence: 99%

“…Ankle joint is one of them. By changing in talar tilt, many studies shown this will result in ankle osteoarthritis, pain and disturb function of ankle 2,3 . These could lead to dissatisfaction of patients.…”

Section: Introductionmentioning

confidence: 99%

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Comparison effect of Anatomical and Conventional tibial cut in post-operative radiographic parameter and clinical outcome of ankle joint in Computer assisted TKA.

Sriphirom¹,

Chompoosaeng²,

Boonton³

EPiC Series in Health Sciences

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In Total knee arthroplasty (TKA), not only knee joint affect when we restored limb alignment, but also other joints involved. Ankle joint is one of them. By changing in talar tilt, many studies shown this will lead to increase pain and disturb function of ankle. Patients may end up with unsatisfied result of TKA. Anatomical cut of tibia is use in order to avoid this problem.To compare between pre- and post-operative talar tilt angle (TTA) and ankle clinical assessment by foot function index (FFI) and ankle-hindfoot index (AHI) after anatomical tibial cut (varus 3° with anatomical axis) and conventional tibial cut (perpendicular with anatomical axis) in computer-assisted total knee arthroplastyThis study was retrospective study. We collected data of 70 knees from 54 patients. 32 knees were done by anatomical cut. The rest were conventional cut. We evaluated at pre- and post-operative for TTA. At 12-month follow-up for TTA & ankle clinical assessment.In conventional group, TTA was changed 2.33°(p<0.001) then 0.920(p=0.02) at follow up. In anatomical group, TTA was changed 2°(p=0.037) then 1.38°(p=1.56). Changing of TTA was not significantly different at post-operatively (p=0.76) and follow-up (p=0.98) between 2 groups. FFI& AHI were not significantly different between both groups.

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The amount of femorotibial alignment correction through total knee arthroplasty may affect postoperative hindfoot alignment

Nakayama,

Tsukada,

Kagami

et al. 2024

J. exp. orthop.

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PurposeThis study was performed to investigate the relationship between the amount of femorotibial alignment correction and the amount of improvement of hindfoot alignment in total knee arthroplasty (TKA).MethodsA total of 159 knees undergoing TKA in 120 patients were assessed preoperatively and at 2 weeks, 1 month, 3 months and 6 months postoperatively. Standing hindfoot alignment was evaluated using the leg‐heel angle (LHA). The amount of change in hindfoot alignment was compared between patients with severe varus knee (Group 1) and those with moderate varus, neutral or valgus knee (Group 2).ResultsThe mean values of pre‐ and postoperative hip‐knee‐ankle (HKA) angle were −14 ± 4° and −1 ± 3° in Group 1 and −7 ± 5° and −1 ± 3° in Group 2, respectively. The differences between pre‐ and postoperative LHA were significantly larger in Group 1 than in Group 2 at 2 weeks, 1 month and 3 months postoperatively (p = 0.006, 0.001 and 0.03, respectively). At 6 months postoperatively, no differences were observed between the two groups (p = 0.31).ConclusionThe amount of change in hindfoot alignment was larger in Group 1 than in Group 2 at 2 weeks, 1 month and 3 months after TKA, but there was no significant difference between the two groups at 6 months after TKA.Level of EvidencePrognostic Level II.

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Radiologic Factors Affecting Ankle Pain Before and After Total Knee Arthroplasty for the Varus Osteoarthritic Knee

Cited by 29 publications

References 11 publications

Poor Correction Capacity of Preexisting Ankle Valgus Deformity after Total Knee Arthroplasty

Poor Correction Capacity of Preexisting Ankle Valgus Deformity after Total Knee Arthroplasty

Comparison effect of Anatomical and Conventional tibial cut in post-operative radiographic parameter and clinical outcome of ankle joint in Computer assisted TKA.

The amount of femorotibial alignment correction through total knee arthroplasty may affect postoperative hindfoot alignment

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