Ankle joint pressure changes in high tibial and distal femoral osteotomies

Krause, Fabian; Barandun, Ariane; Klammer, Georg; Gueorguiev, Boyko; Schmid, Timo

doi:10.1302/0301-620x.99b1.38054

Cited by 15 publications

(30 citation statements)

References 26 publications

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“…Therefore, the hindfoot flexibility can influence the calcaneus position after the correction of genu varum deformity. A previous cadaveric study also showed that the lateral migration of ankle joint pressure was more significant when the subtalar joint was fixed in the varus position [10]. Second, total knee arthroplasty and HTO can change the rotational alignment of the lower extremities [20,21].…”

Section: Discussionmentioning

confidence: 92%

“…Conversely, few studies evaluated the WBL ratio of the ankle joint after knee arthroplasty or HTO, although it is an HKA, hip-knee-ankle; WBL, weight-bearing line; AJLO-G, ankle joint line orientation relative to the ground important factor that affects the joint biomechanics and load distribution [10,11]. This was due to the lack of radiologic techniques to measure the WBL ratio of the ankle joints.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, varus and valgus alignments Despite these limitations, this study can provide an additional rationale for the development of ankle joint pain or osteoarthritis progression after knee arthroplasty or HTO in patients with genu varum deformity. Previous cadaveric studies reported that proximal realignment surgeries altered the ankle pressure distribution [10,11]. In these studies, the peak joint pressure was decreased and the center of joint pressure was shifted laterally after correction using varus malalignment surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, it seems insufficient to explain the causes of ankle pain and arthritis changes. Few studies have evaluated the change in the weight-bearing line (WBL) ratio of ankle joint, one of the most important factors affecting the joint biomechanics and load distribution [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity

Kim

Choi

Koo

et al. 2020

International Orthopaedics (SICOT)

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Purpose Several studies reported that excessive correction of severe genu varum deformity with total knee arthroplasty or high tibial osteotomy (HTO) could result in ankle joint pain and osteoarthritis progression. However, few studies have evaluated the change in the weight-bearing-line (WBL) ratio of the ankle joint after knee arthroplasty or HTO in patients with genu varum deformities. This study aimed to investigate the change in the WBL ratio of the ankle joint and ankle joint line orientation after knee arthroplasty or HTO in patients with genu varum deformities. Methods We retrospectively evaluated 40 patients (mean age, 69.9 ± 8.0 years) with genu varum deformities of > 5°and underwent knee arthroplasty or HTO. Three radiologic parameters, including (1) the hip-knee-ankle (HKA) angle, (2) WBL ratio of the ankle joint, and (3) ankle joint line orientation relative to the ground (AJLO-G), were assessed using pre-operative and post-operative orthoradiographs. A paired t test was used to evaluate post-operative changes in the three parameters. Correlations between the change in HKA angle and that in the WBL ratio of the ankle joint and AJLO-G were analyzed. ResultsThe mean HKA angle significantly decreased post-operatively (10.6°± 5.3°to 1.1°± 3.4°; P < 0.001). The WBL ratio of the ankle joint increased from 35.8% ± 15.2% to 53.0% ± 17.4% (P < 0.001), with a lateral shift of the mechanical axis. The AJLO-G decreased with valgization of ankle orientation (7.8°± 4.8°to 0.4°± 3.8°; P < 0.001). The change in the HKA angle was significantly correlated with that in the AJLO-G (correlation coefficient = 0.716; P < 0.001) but not with the change in the WBL ratio of the ankle joint. Conclusion Knee arthroplasty and HTO corrected the genu varum deformity, which influenced the lateral shift of the WBL of the ankle joint and valgization of the ankle joint line orientation.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity

Kim

Choi

Koo

et al. 2020

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

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“…According to a cadaveric study by Suero et al, 10 moderate to large changes in proximal tibial alignment by medial open‐wedge HTO resulted in a significantly decreased tibiotalar contact surface area and changes in intraarticular ankle pressures. Another cadaveric study also assessed the effect of HTO and distal femoral osteotomies on the pressure characteristics of the ankle joint 11 . They examined the effect on various conditions including two different (5 and 10) degrees of realigning osteotomy, and whether the subtalar joint was either mobile or fixed.…”

Section: Introductionmentioning

confidence: 99%

Change in intersegmental foot and ankle motion after a high tibial osteotomy in genu varum patients

Kyung

Cho

Hwang

et al. 2020

Journal Orthopaedic Research

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High tibial osteotomy (HTO) is a well-established treatment for medial compartment knee osteoarthritis (OA), which shifts the weight-bearing axis from the medial to the lateral side of the knee. As the adjacent ankle joint may be directly affected by the change in biomechanics, this study aimed to evaluate the change in the intersegmental foot and ankle motion after HTO in patients with genu varum. The study SUPPORTING INFORMATION

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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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Ankle joint pressure changes in high tibial and distal femoral osteotomies

Cited by 15 publications

References 26 publications

Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity

Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity

Change in intersegmental foot and ankle motion after a high tibial osteotomy in genu varum patients

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

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