2023 ISAKOS Biennial Congress ePoster
Effect of Restricted Kinematic Alignment Total Knee Arthroplasty on Coronal Plane Alignment Of The Ankle Joint
Bartosz Michał Maciąg, MD, Warsaw, Mazowieckie POLAND
Marcin Łapiński, MD, Warsaw, Mazowieckie POLAND
Tomasz Mrozek, MD, Białystok, Podlaskie POLAND
Adrian Góralczyk, MD, Bialystok POLAND
Maciej Swiercz, MD, Warsaw POLAND
Grzegorz Maciąg POLAND
Krystian Żarnovsky POLAND
Olga Adamska POLAND
Artur Stolarczyk, MD, PhD, Jozefow POLAND
Department of Orthopaedics and Rehabilitation, Medical University of Warsaw, Warsaw, Mazowieckie, POLAND
FDA Status Cleared
Summary
This prospective study confirms that total knee arthroplasty influences the angles and potentially biomechanics in the ankle joint with change in ankle joint line orientation angle (AJOA) and tibial plafond talus angle (PTA).
ePosters will be available shortly before Congress
Abstract
Introduction
Total knee arthroplasty often changes limb alignment and biomechanical gait parameters. Restoration of the proper knee mechanical axis has a proven impact on the hip joint at least its range of motion. However, very little is known about its influence on other lower limb articulations, including ankle joint.
Aim
of the study:
The purpose of this study is to evaluate how total knee replacement affects ankle joint coronal alignment.
Material And Methods
This prospective study included 65 patients (40 females, 22 males) who had undergone total knee replacement due to primary osteoarthritis. They were divided into two groups depending on the degree of knee coronal alignment deformity: group 1 (<10° varus deformity), group 2 (>10° varus deformity). All patients’ coronal knee alignment was corrected intraoperatively in concept of restricted kinematic alignment. In every case a standard preoperative and postoperative (6 weeks following the surgery) radiological examination was performed. Obtained antero-posterior full-leg weight-bearing radiographs were used to measure lower limb mechanical axis (HKA), medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), lateral distal tibial angle (LDTA), ankle joint line orientation angle (AJOA) and tibial plafond talus angle (PTA).
Results
There was significant positive weak association between change of AJOA and change of both HKA and MPTA (rs=0.34, p=0.007 and rs=0.26,p=0.042, respectively). There was significant difference between group with HKA values between 177-184 degrees and the group with other values in change of PTA (-0.72(-1.57-0.06 vs. 0.33(-0.71-0.79), p=0.019). There was no significant difference between HKA values between 177-184 degrees and the group with other values in regard to change of AJOA. There was no significant difference between the group with change of HKA greater than 3 degrees in comparison to the group with HKA change less or equal to 3 degrees, both in regard to change of AJOA and PTA.
Conclusion
The correction of knee joint malalignment does affect ankle joint abnormalities. Any discomfort, ankle pain or gait disorders after TKA might have origin in this changes. For this reason surgeons should keep in mind that TKA may not be the only surgery needed in multiarticular mechanical axis deviations and if necessary broaden diagnostics process and engage other treatment methods in patients, especially those complaining about ankle joints.