Abstract
This study investigated the differences in ankle alignment changes after TKA in patients with varying preexisting ankle deformities. We retrospectively examined 90 knees with osteoarthritis and varus deformity in 78 patients who underwent TKA. Preoperative and postoperative radiographic parameters were analyzed. According to their preexisting ankle deformity, patients were assigned to the valgus or varus group. Overall, 14 (15.6%) cases were of preoperative valgus ankle deformity; the remainder were of preoperative varus ankle deformity. Hip–knee–ankle angle (HKA), tibial plafond–ground angle (PGA), and talus–ground angle (TGA) all exhibited significant correction in both groups; however, tibial plafond–talus angle (PTA) and superior space of ankle joint (SS) only changed in the varus group. The median PTA and SS significantly decreased from 1.2° to 0.3° (p < 0.001) and increased from 2.5 to 2.6 mm (p = 0.013), respectively. Notably, ∆PTA positively correlated with ∆HKA in the varus group (r = 0.247, p = 0.032) but not in the valgus group. Between-group differences in postoperative PTA (p < 0.001) and ∆PTA (p < 0.001) were significant. The degree of ankle alignment correction after TKA differed between patients with preexisting varus and valgus ankle deformities. TKA could not effectively correct the preexisting ankle valgus malalignment.
Highlights
Total knee arthroplasty (TKA) is considered the gold standard for treating end-stage knee osteoarthritis (OA)
To reduce the potential effects of preoperative knee deformity on the results, we only included patients with varus knee deformities defined by a preoperative hip–knee–ankle angle (HKA) of >0◦
The median (IQR) ∆plafond–talus angle (PTA) in the varus and valgus groups was −0.7◦ (−1.6◦ to −0.2◦ ) and 0.4◦ (−0.5◦ to 1.4◦ ; p < 0.001), respectively. These results reveal that TKA exerted significantly different effects in the correction of varus and valgus ankle deformities
Summary
Total knee arthroplasty (TKA) is considered the gold standard for treating end-stage knee osteoarthritis (OA). Studies have proved the effectiveness of TKA in alleviating pain and improving functional outcome [1,2]. In clinical scenarios, some patients complain of aggravation of ankle pain after surgery. Some of these patients have preexisting ankle OA [3,4,5,6]. Ankle pain following TKA is very troublesome and is associated with poorer clinical outcomes [3,5,7]. To implement TKA in patients with both knee and ankle problems, one must consider possible postoperative changes in ankle alignment in the context of preventing ankle symptom exacerbation
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