Correction of excessive intraarticular varus deformities in total knee arthroplasty is associated with deteriorated postoperative ankle function

被引:13
作者
Graef, Frank [1 ,2 ]
Falk, R. [3 ]
Tsitsilonis, S. [1 ]
Perka, C. [1 ]
Zahn, R. K. [1 ]
Hommel, H. [1 ,3 ]
机构
[1] Charite Univ Med Berlin, Ctr Musculoskeletal Surg, Charitepl 1, D-10117 Berlin, Germany
[2] Berlin Inst Hlth, Anna Louisa Karsch Str 2, D-10178 Berlin, Germany
[3] Mark Oderland Hosp, Brandenburg Med Sch Theodor Fontane, Dept Orthopaed, Wriezen, Germany
关键词
Total knee arthroplasty; Total knee replacement; Ankle joint; Osteoarthritis knee; Interplay knee ankle; HIGH TIBIAL OSTEOTOMY; CORONAL ALIGNMENT; TIBIOTALAR JOINT; SUBTALAR JOINT; OSTEOARTHRITIS; VALIDATION; ADDUCTION;
D O I
10.1007/s00167-019-05812-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
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 degrees) 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.
引用
收藏
页码:3758 / 3765
页数:8
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