Correlation between knee and hindfoot alignment in patients with rheumatoid arthritis: The effects of subtalar joint destruction

Nakada, Izumi; Nakamura, Ichiro; Juji, Takuo; Ito, Katsuhiko; Matsumoto, Takumi

doi:10.3109/14397595.2015.1008726

Cited by 13 publications

(19 citation statements)

References 32 publications

(46 reference statements)

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“…In patients with OA of the knee, the moderate correlation between knee and ankle alignment is reported [ 1 , 21 ]. For patients of RA with low Larsen grades, the correlation in the previous study [ 14 ] and in this cohort were both weak. The object of OA study was patients undergoing TKA, who tend to have severe deformity, and the deformity of the knee was milder in RA cohorts.…”

Section: Discussioncontrasting

confidence: 66%

“…In the pioneer study of Nakada et al [ 14 ], the TCA does not correlate to the FTA when the Larsen grade of the subtalar joint is 4 or more. The main difference in our study is the method of radiography; we used H-to-C methods [ 15 ] in order to measure FTA and THFA in one X-ray film.…”

Section: Discussionmentioning

confidence: 99%

“…Second, the coronal deformity of the knee and ankle joints was only evaluated by H-to-C X-ray, so three-dimensional information was not available, and the effect of the femoral and tibial rotation could not be excluded. In addition, the FTA of H-to-C X-ray may not be identical to the FTA in the standard full-length anteroposterior X-ray which is used in other studies [ 1 , 14 ], since knee joint might be slightly flexed because of the dorsiflexion or forefoot. Third, the pain in the hindfoot was described, but this pain was only as reported by the patient, so the localization of the pain was not included.…”

Section: Discussionmentioning

confidence: 99%

“…Nakada et al report a significant correlation between femorotibial and tibiocalcaneal angles (TCA) in patients with RA [ 14 ]. In their evaluations of the radiographs, the TCA was used as the coronal hindfoot alignment, but the total hindfoot (talus-calcaneus) was not evaluated, and they used the different radiographs to evaluate the FTA and TCA.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…7,[27][28][29]41 HFA measures based on 2D radiographs are flawed by many anatomical and operator-related bias, which have been extensively investigated in the literature. * These include projection and rotational issues, 3,22 mostly with regards to the use of the tibia as a reference axis.…”

Section: Introductionmentioning

confidence: 99%

3D Biometrics for Hindfoot Alignment Using Weightbearing CT

Lintz

Welck

Bernasconi³

et al. 2017

Foot Ankle Int.

135

162

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Background: Hindfoot alignment on 2D radiographs can present anatomical and operator-related bias. In this study, software designed for weightbearing computed tomography (WBCT) was used to calculate a new 3D biometric tool: the Foot and Ankle Offset (FAO). We described the distribution of FAO in a series of data sets from clinically normal, varus, and valgus cases, hypothesizing that FAO values would be significantly different in the 3 groups. Methods: In this retrospective cohort study, 135 data sets (57 normal, 38 varus, 40 valgus) from WBCT (PedCAT; CurveBeam LLC, Warrington, PA) were obtained from a specialized foot and ankle unit. 3D coordinates of specific anatomical landmarks (weightbearing points of the calcaneus, of the first and fifth metatarsal heads and the highest and centermost point on the talar dome) were collected. These data were processed with the TALAS system (CurveBeam), which resulted in an FAO value for each case. Intraobserver and interobserver reliability were also assessed. Results: In normal cases, the mean value for FAO was 2.3% ± 2.9%, whereas in varus and valgus cases, the mean was −11.6% ± 6.9% and 11.4% ± 5.7%, respectively, with a statistically significant difference among groups (P < .001). The distribution of the normal population was Gaussian. The inter-and intraobserver reliability were 0.99 +/-0.00 and 0.97 +/-0.02 Conclusions: This pilot study suggests that the FAO is an efficient tool for measuring hindfoot alignment using WBCT. Previously published research in this field has looked at WBCT by adapting 2D biometrics. The present study introduces the concept of 3D biometrics and describes an efficient, semiautomatic tool for measuring hindfoot alignment. Level of Evidence: Level III, retrospective comparative study.

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A New Concept of 3D Biometrics for Hindfoot Alignment Using Weight Bearing CT

Lintz¹

2019

Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle

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Correlation between knee and hindfoot alignment in patients with rheumatoid arthritis: The effects of subtalar joint destruction

Abstract: These findings emphasized the importance of examining foot and ankles in patients with RA who undergo total knee arthroplasty.

Cited by 13 publications

References 32 publications

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

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

3D Biometrics for Hindfoot Alignment Using Weightbearing CT

A New Concept of 3D Biometrics for Hindfoot Alignment Using Weight Bearing CT

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