Changes in coronal alignment of the ankle joint after high tibial osteotomy

Choi, Gi Won; Yang, Jae Hyuk; Park, Jung Ho; Yun, Ho Hyun; Lee, Yong In; Chae, Jin Eon; Yoon, Jung Hwan

doi:10.1007/s00167-015-3890-3

Cited by 46 publications

(74 citation statements)

References 25 publications

(30 reference statements)

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“…1,2 However, inability of these joints to completely reorient themselves after knee realignment may predispose to foot or ankle symptoms. 1,2,5 We feel this may have predisposed to ankle and hindfoot symptoms in the symptomatic group in our study.…”

Section: Discussionmentioning

confidence: 73%

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Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

2018

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Medial open wedge high tibial osteotomy (MOWHTO) is a commonly performed procedure for symptomatic medial compartment osteoarthritis (OA). However, little is known about its effects on ipsilateral ankle or hindfoot. The aim of our study was to determine the incidence of ankle or hindfoot problems after MOWHTO and examine its association with radiological indices. Thirty-five knees (32 patients) undergoing navigated MOWHTO were evaluated for the presence of new-onset ankle or hindfoot symptoms after surgery. Pre- and postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and tibial plafond inclination (TPI) were measured and compared on standing lower limb alignment radiographs. The mean postoperative change in HKA angle, MPTA, and TPI was 8.8°, 7.0°, and 8.4°, respectively. New-onset unexplained ankle or hindfoot symptoms were seen in 20% of the cases after surgery. Postoperative change in TPI was significantly greater in symptomatic patients as compared with asymptomatic ones (12.8° ± 4.9° vs. 8.1° ± 4.8°, = 0.03). The odds ratio (OR) for developing ankle or hindfoot symptoms in cases with ≥ 10° change in TPI postoperatively was 10.8 ( = 0.04). Ankle or hindfoot symptoms were successfully managed with conservative treatment in all cases.

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Section: Discussionmentioning

confidence: 73%

“…Incidence of new-onset ankle or hindfoot problems following MOWHTO has not been previously reported. Choi et al 5 reported that ankle symptoms were affected by coronal alignment changes in the ankle after MOWHTO. However, their study also included patients with preexisting ankle pain.…”

Section: Discussionmentioning

confidence: 99%

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

2018

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“…Lee et al found that the change of KJLO was signi cantly less than that of anatomical geometry of the proximal tibia. This phenomenon can be explained by the compensation of the ankle joint [8,18]. However, the capacity of compensation differs among individuals [9,15,25], and currently there is no information about the maximum of the capacity for most of the patients undergoing MOWHTO.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…Varus knee deformity of the OA knee tends to have valgus hindfoot, and vice versa. In some previous reports, the change in the alignment of the knee due to a surgical intervention, such as total knee arthroplasty (TKA) [ 2 , 3 , 5 ] or high tibial osteotomy, [ 6 ] affects the alignment of the hindfoot within a short time after the surgery. Meanwhile, in rheumatoid arthritis (RA), it is not evident whether the compensatory correlation of the angle of the knee and hindfoot which is observed in OA patients can be applied using the same theory.…”

Section: Introductionmentioning

confidence: 99%

Correlation in the Coronal Angle between Knee and Hindfoot Was Observed in Patients with Rheumatoid Arthritis Unless Talocrural Joint Was Destroyed

Nishitani

Ito

Shimozono

et al. 2017

BioMed Research International

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The purpose of this study is to investigate the compensatory correlation between knee and hindfoot in patients with rheumatoid arthritis (RA). This cross-sectional study included 218 patients (407 lower extremities). Radiographs of the hindfoot and full-length posteroanterior hip-to-calcaneus standing radiographs were evaluated. The destruction of the hindfoot was evaluated using the Larsen grading system. The coronal angular deformity of the knee and hindfoot was evaluated by the femorotibial angle (FTA) and the angle between the tibial shaft and the entire hindfoot (tibiohindfoot angle, THFA). The correlation between FTA and THFA was determined by Pearson's coefficient. For all patients, FTA correlated to THFA (R = 0.28, p < 0.001). The correlation was observed as long as the talocrural joint was preserved (Larsen grade ≤ 2), even if the subtalar joint had been destroyed (Larsen grade ≥ 3). However, the correlation was not observed when the talocrural joint was destroyed (Larsen grade ≥ 3, R = −0.02, p = 0.94). The pain in the hindfoot did not correlate with FTA or THFA. In conclusion, a compensatory deformity of the hindfoot against the deformity of the knee was observed in RA, and the correlation was lost when talocrural joint was destroyed.

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Changes in coronal alignment of the ankle joint after high tibial osteotomy

Abstract: III.

Cited by 46 publications

References 25 publications

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

Ankle and Hindfoot Symptoms after Medial Open Wedge High Tibial Osteotomy

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

Correlation in the Coronal Angle between Knee and Hindfoot Was Observed in Patients with Rheumatoid Arthritis Unless Talocrural Joint Was Destroyed

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