Diagnosis and Management of Extra-articular Causes of Pain After Total Knee Arthroplasty.

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Abstract

[Indexed for MEDLINE] 17. J Clin Orthop Trauma. 2022 Jul 9;31:101947. doi: 10.1016/j.jcot.2022.101947. eCollection 2022 Aug. Evaluation of the hindfoot alignment before and after total knee arthroplasty. Yamasaki Y(1), Maeyama A(1), Miyazaki K(1), Ishimatsu T(1), Yoshimura I(1), Yamamoto T(1). Author information: (1)Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan. BACKGROUND: Open wedge high tibial osteotomy (OWHTO) and total knee arthroplasty (TKA) alter the ankle joint line obliquity (AJLO) to be more horizontal relative to the ground and aligns the valgus subtalar joint (SJ) neutrally. A previous study of the hindfoot alignment angle (HAA) showed that lower limb alignment after OWHTO becomes under-corrected because of abnormal compensation by the SJ. However, because TKA can exclude effects of femorotibial joint instability, analysis of a post-TKA cohort enables a more accurate evaluation of SJ compensation than analysis of a post-OWHTO cohort. In the present study, we performed radiographic evaluations before and after TKA to analyze SJ compensation. METHODS: Lower limb and hindfoot alignment were measured on plain radiographs in 46 patients (48 knees) who underwent TKA in our department. The patients were divided into Group A (postoperative AJLO within ±1°) and Group B (postoperative AJLO greater than ±1°), and various parameters were compared between the groups. The preoperative HAA that resulted in an abnormal postoperative AJLO was investigated. RESULTS: Group A had a significantly smaller preoperative HAA (p = 0.03) and postoperative HAA (p