Summary: This study used the distal point at the clear calcaneal contour as reference point in the measurements of hip-to-calcaneus angle (HCA) and tibia-calcaneus angle (TCA) using the full-length standing lower extremity anteroposterior (AP) radiograph pre- and post-TKA up to 2 years follow-up.

Background

The mechanical axis is conventionally used for evaluating the alignment of the lower extremity during total knee arthroplasty (TKA), not considering the effect of osteoarthritis (OA) on the hindfoot and the changes that occur particularly in the subtalar joint after TKA. This study aimed to compare pre- and post-TKA measurements up to 2 years follow-up using the conventional mechanical axis to the hip-to-calcaneus axis (HCA) and using tibia-calcaneus angle (TCA) as a measure of subtalar compensation to see the changes that happens to the subtalar joint over time.

Methods

All patients diagnosed with varus osteoarthritis that underwent TKA in Nara Medical University Hospital from 2016-2020 under one Orthopaedic surgeon with 2 years follow-up were included in the study. The following were excluded: previous surgery in lower extremity, revision TKA, patients with rheumatoid arthritis, valgus knee, patients with incomplete data. Full-length standing lower extremity anteroposterior radiographs were used to define the reference points and determine the mechanical axis of the lower extremity, HCA, and TCA pre-TKA, post-TKA first follow-up, 1-year post-TKA, and 2 years post-TKA.

Results

There was a total of 45 (55 knees) included in the study composed of 9 male patients with mean age of 77.7 years old and 36 females with mean age of 73.8 years old at the time of surgery. Mixed model regression analysis showed that HCA had similar trend in the line graph with preoperative values of HCA (107%) compared to MA (109%) and had HCA values (58%, 61%, 60%) compared to values of MA (64%, 66%, 65%) post-op, 1st year, and 2nd year post-op respectively. These findings coincide with the results of Hip-Knee-Angle (HKA) and Femoral-Tibial Angle (FTA) which significantly dropped post-op with slight increase at 1st year post-op and plateaus at 2nd year post-op.
Mean pre-op TCA of 12.51 degrees which significantly decreased to 9.20 degrees post-op and continued to decrease to 8.85 degrees at 1st year post-op and 8.44 degrees at 2nd year post-op. The Ankle Joint Line Orientation (AJLO) had a significant drop post-op and Talar tilt (TT) improved post-op but did not reach statistical significance.

Conclusion

The findings of this study showed a similar trend in the improvement of MA, HCA, HKA, and FTA with a significant decrease on first follow-up with a slight increase at 1-year post-TKA then plateaus at 2-year post-TKA.
The TCA had a significant improvement from pre-TKA to post-TKA then plateaus on the succeeding years signifying subtalar joint compensation. Once the varus knee is corrected by TKA, the subtalar joint compensates with the deformity and is corrected. These findings are consistent with previous reports. The subtalar joint can be measured on the same full-length standing lower extremity anteroposterior radiograph suggesting that it may be useful for evaluating the lower extremity alignment, including the calcaneal loading area.

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Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
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Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
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Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Central Sensitization is Associated with Persistent Postoperative Pain and Inferior Patient-Reported Outcomes in Patients Undergoing Unicompartmental Knee Arthroplasty ePoster Presentation Yong In, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF
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Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
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Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
A Prospective Randomised Study to Compare the Clinical and Radiological Outcomes of Functionally Aligned versus Mechanically Aligned Total Knee Arthroplasty with Robotic Arm Assistance ePoster Presentation Jai Thilak Kailathuvalapil, MS, MCh, FRCS, INDIA Amal Antony Paul, MBBS, INDIA
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
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No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
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Differences In Pain, Sleep Status And Functional Recovery Between TKA And UKA ePoster Presentation Takeo Mammoto, MD, JAPAN
Same Complication Rate After Day-Case Procedure Or Fast-Track Procedure After Total Hip And Knee Arthroplasty. A Prospective, Propensity Score-Matched Case-Control Study ePoster Presentation Jean-Yves Jenny, Prof., FRANCE Vincent Gisonni, MD, FRANCE
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
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Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Participation of Physical Activity Following Knee Arthroplasty: A Meta-Analysis ePoster Presentation Ahmed A Magan, BM BSc (Hons) MRCS (Eng) FRCS (Eng) Trauma & Orth, UNITED KINGDOM Babar Kayani, BSc (HONS), MBBS, MRCS (Eng), UNITED KINGDOM Warran Wignadasan, MBBS, BSc (Hons), MRCS, UNITED KINGDOM Dia Eldean Giebaly, MBChB, MSc, FRCS, EMBA, UNITED KINGDOM Flaminia Ronca, PHD, UNITED KINGDOM Fares S. Haddad, MCh(Orth), BSc, FRCS(Orth), UNITED KINGDOM
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Deepak Gupta, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA
Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty ePoster Presentation Yushi Sakamoto, MD, JAPAN Shinichiro Nakamura, MD, PhD, JAPAN Yugo Morita, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Yusuke Yamawaki, MD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Evaluation of The Safety And Efficacy of The Fully Automated Active Robotic System In Robotic Assisted Total Knee Arthroplasty ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos, MD, PhD, SPAIN
Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study ePoster Presentation Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS, INDIA
Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, UNITED STATES
Palliative Arthroscopic Debridement with Continuous Irrigation for the Infection TKA of High Mortality Risk Patients ePoster Presentation Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Yoon Cheol Nam, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF
Use of Tibial Stem for Patients with Morbid Obesity in Total Knee Arthroplasty ePoster Presentation José Eduardo Flores Naranjo, MD, MEXICO Adrian Aziz Cortes De La Fuente, MD, MEXICO Octavio Martinez Montiel, MD, MEXICO Fernando Martinez Zuñiga, MD, MEXICO

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Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up

Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up

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Conclusion

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Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up

Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up

Background

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content