Increasing grades of frontal deformities in knee osteoarthritis are not associated with ligamentous ankle instabilities

Graef, Frank; Rühling, Marlene; Gwinner, Clemens; Hommel, Hagen; Tsitsilonis, Serafeim; Perka, Carsten

doi:10.1007/s00167-022-07021-3

Cited by 2 publications

(1 citation statement)

References 37 publications

(48 reference statements)

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“…In case of a decreased ROM of the subtalar joint, compensation of valgus/varus malalignments in the knee joint might then take place in the ankle joint and lead to ankle osteoarthritis [27,38]. A recent study, however, found that in patients with osteoarthritis of the knee joint, higher degrees of varus or valgus deformation at the knee joint were not associated with a decrease or increase of the ROM of the subtalar joint [41].…”

Section: Discussionmentioning

confidence: 99%

Functional gait analysis reveals insufficient hindfoot compensation for varus and valgus osteoarthritis of the knee

Rühling

Kirschbaum

Perka

et al. 2023

International Orthopaedics (SICOT)

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Purpose The hindfoot is believed to compensate varus and valgus deformities of the knee by eversion and inversion movements. But these mechanisms were merely found in static radiologic measurements. The aim of this study was, therefore, to assess dynamic foot posture during gait using pressure-sensitive wireless insoles in patients with osteoarthritis of the knee and frontal knee deformities. Methods Patients with osteoarthritis of the knee were prospectively included in this study. Patients were clinically and radiologically (mechanical tibiofemoral angle (mTFA), hindfoot alignment view angle (HAVA), and talar tilt (TT)) exa mined. Gait line analysis was conducted using pressure-sensitive digital shoe insoles. Results Eighty-two patients (varus n = 52, valgus n = 30) were included in this prospective clinical study. Radiologically, the mTFA significantly correlated with the HAVA (cor = −0.72, p < 0.001) and with the TT (Pearson’s cor = 0.32, p < 0.006). Gait analysis revealed that the gait lines in varus knee osteoarthritis were lateralized, despite the hindfoot valgus. In valgus knee osteoarthritis, gait lines were medialized, although the hindfoot compensated by varization. Conclusions Functional dynamic gait analysis could demonstrate that the hindfoot is not able to sufficiently compensate for frontal malalignments of the knee joint, contrary to static radiologic findings. This led to a narrowing of the joint space of the ankle medially in varus and laterally in valgus knee osteoarthritis.

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Section: Discussionmentioning

confidence: 99%

Functional gait analysis reveals insufficient hindfoot compensation for varus and valgus osteoarthritis of the knee

Rühling

Kirschbaum

Perka

et al. 2023

International Orthopaedics (SICOT)

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Increased ankle pain after total knee arthroplasty is associated with a preoperative lateralized gait and talar tilt, but not with ankle laxity or the range of motion of the subtalar joint

Rühling,

Kirschbaum,

Perka

et al. 2023

Bone Joint J

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AimsTotal knee arthroplasty (TKA) may provoke ankle symptoms. The aim of this study was to validate the impact of the preoperative mechanical tibiofemoral angle (mTFA), the talar tilt (TT) on ankle symptoms after TKA, and assess changes in the range of motion (ROM) of the subtalar joint, foot posture, and ankle laxity.MethodsPatients who underwent TKA from September 2020 to September 2021 were prospectively included. Inclusion criteria were primary end-stage osteoarthritis (Kellgren-Lawrence stage IV) of the knee. Exclusion criteria were missed follow-up visit, post-traumatic pathologies of the foot, and neurological disorders. Radiological angles measured included the mTFA, hindfoot alignment view angle, and TT. The Foot Function Index (FFI) score was assessed. Gait analyses were conducted to measure mediolateral changes of the gait line and ankle laxity was tested using an ankle arthrometer. All parameters were acquired one week pre- and three months postoperatively.ResultsA total of 69 patients (varus n = 45; valgus n = 24) underwent TKA and completed the postoperative follow-up visit. Of these, 16 patients (23.2%) reported the onset or progression of ankle symptoms. Varus patients with increased ankle symptoms after TKA had a significantly higher pre- and postoperative TT. Valgus patients with ankle symptoms after TKA showed a pathologically lateralized gait line which could not be corrected through TKA. Patients who reported increased ankle pain neither had a decreased ROM of the subtalar joint nor increased ankle laxity following TKA. The preoperative mTFA did not correlate with the postoperative FFI (r = 0.037; p = 0.759).ConclusionApproximately one-quarter of the patients developed ankle pain after TKA. If patients complain about ankle symptoms after TKA, standing radiographs of the ankle and a gait analysis could help in detecting a malaligned TT or a pathological gait.Cite this article: Bone Joint J 2023;105-B(11):1159–1167.

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Increasing grades of frontal deformities in knee osteoarthritis are not associated with ligamentous ankle instabilities

Cited by 2 publications

References 37 publications

Functional gait analysis reveals insufficient hindfoot compensation for varus and valgus osteoarthritis of the knee

Functional gait analysis reveals insufficient hindfoot compensation for varus and valgus osteoarthritis of the knee

Increased ankle pain after total knee arthroplasty is associated with a preoperative lateralized gait and talar tilt, but not with ankle laxity or the range of motion of the subtalar joint

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