Search Filters

  • Media Source
  • Presentation Format
  • Media Type
  • Media Year
  • Language
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

Effect of Restricted Kinematic Alignment Total Knee Arthroplasty on Coronal Plane Alignment Of The Ankle Joint

Effect of Restricted Kinematic Alignment Total Knee Arthroplasty on Coronal Plane Alignment Of The Ankle Joint

Bartosz Michał Maciąg, MD, POLAND Marcin Łapiński, MD, POLAND Tomasz Mrozek, MD, POLAND Adrian Góralczyk, MD, POLAND Maciej Swiercz, MD, POLAND Grzegorz Maciąg, POLAND Krystian Żarnovsky, POLAND Olga Adamska, POLAND Artur Stolarczyk, MD, PhD, POLAND

Department of Orthopaedics and Rehabilitation, Medical University of Warsaw, Warsaw, Mazowieckie, POLAND


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Patient Populations

Diagnosis Method

Sports Medicine


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).


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.


More 2023 ISAKOS Congress Content