Abstract
It is important to evaluate the subtalar joint and hip-knee-ankle alignment to understand lower extremity alignment. In this review, we focused on the compensatory changes in the subtalar joint alignment for the deformity of the knee and ankle joint, reviewing previous research. The subtalar joint alignment was compensatory valgus in patients with varus knee and ankle deformity, whereas it was uncertain whether the subtalar joint alignment was compensatory varus in patients with valgus knee and ankle deformity. The subtalar joint valgus alignment improved after total knee arthroplasty or high tibial osteotomy for varus knee deformity, even if the deformity was severe. In contrast, whether the subtalar joint alignment changed after the surgery for ankle or valgus knee deformity has not been considered. Further research on the compensatory function of the subtalar joint is needed.
Highlights
When treatment for lower extremity malalignment is needed, it is important to evaluate the lower extremity alignment correctly
Recent studies have discussed the compensatory function of the subtalar joint [7, 13, 19]: several reports show that the subtalar joint compensates for the deformities of the knee and ankle joints [10, 12, 17, 18, 20], and the subtalar joint alignment which was 2∘-6∘ valgus in healthy legs [21, 22] changed after surgery to correct these deformities [7, 14, 16]
The correlation coefficient between hindfoot angle and mechanical axis angle was -0.413 and was -0.536 for those with larger knee deformity. These results indicate that the hindfoot alignment was compensatory valgus in patients with varus knee osteoarthritis (OA) and was varus in patients with valgus knee OA
Summary
When treatment for lower extremity malalignment is needed, it is important to evaluate the lower extremity alignment correctly. As calcaneus is in contact with the ground, it is necessary to evaluate the alignment of the subtalar joint in addition to the hip-knee-ankle alignment to correctly measure the lower extremity alignment [4]. Recent studies have discussed the compensatory function of the subtalar joint [7, 13, 19]: several reports show that the subtalar joint compensates for the deformities of the knee and ankle joints [10, 12, 17, 18, 20], and the subtalar joint alignment which was 2∘-6∘ valgus in healthy legs [21, 22] changed after surgery to correct these deformities [7, 14, 16]. When surgery for knee or ankle deformity is needed, it is helpful for surgical planning to understand the mechanism of subtalar joint compensation and how the subtalar joint alignment changes after surgery. We discuss the compensatory function of the subtalar joint in patients with deformities of the lower extremity, reviewing previous research
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