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Correction of excessive intraarticular varus deformities in total knee arthroplasty is associated with deteriorated postoperative ankle function.
Graef, Frank; Falk, R; Tsitsilonis, S; Perka, C; Zahn, R K; Hommel, H.
Afiliación
  • Graef F; Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany. frank.graef@charite.de.
  • Falk R; Berlin Institute of Health, Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany. frank.graef@charite.de.
  • Tsitsilonis S; Department of Orthopaedics, Märkisch-Oderland Hospital, Brandenburg Medical School Theodor Fontane, Wriezen, Germany.
  • Perka C; Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Zahn RK; Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Hommel H; Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Knee Surg Sports Traumatol Arthrosc ; 28(12): 3758-3765, 2020 Dec.
Article en En | MEDLINE | ID: mdl-31776626
PURPOSE: The aim of this study was to demonstrate, whether the degree of limb alignment correction in varus knee osteoarthritis correlated with an increase in ankle symptoms and to define a cut-off value concerning the degree of correction above which to expect ankle problems. METHODS: Ninety-nine consecutive patients with preoperative intraarticular varus knee deformities who underwent total knee arthroplasty were retrospectively analyzed. Patients were examined clinically (Knee Society Score, Forgotten Joint Score, Foot Function Index, Range of Motion of the knee and ankle joint, pain scales) as well as radiologically. The mean follow-up time was 57 months. RESULTS: The degree of operative limb alignment correction strongly correlated with the Foot Function Index (R = 0.91, p < 0.05). Given this, higher degrees of knee malalignment corrections were associated with worse postoperative outcomes in the knee and ankle joint-despite postoperative improved joint line orientations. Subsequently, a cut-off value for arthritic varus deformities (14.5°) could be calculated, above which the prevalence of ankle symptoms increased manifold [OR = 15.6 (3.2-77.2 95% CI p < 0.05)]. Furthermore, ROM restrictions in the subtalar joint were associated with a worse outcome in the ankle joint. CONCLUSIONS: When correcting excessive intraarticular varus knee osteoarthritis, surgeons have to be aware of possible postoperative ankle symptoms and should consider ankle deformities or decreased subtalar ROM before operative procedures. LEVEL OF EVIDENCE: III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla / Articulación del Tobillo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Osteoartritis de la Rodilla / Articulación del Tobillo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania