dc.contributor.author
Graef, Frank
dc.contributor.author
Hommel, Hagen
dc.contributor.author
Falk, Roman
dc.contributor.author
Tsitsilonis, Serafeim
dc.contributor.author
Zahn, Robert Karl
dc.contributor.author
Perka, Carsten
dc.date.accessioned
2022-11-10T12:58:24Z
dc.date.available
2022-11-10T12:58:24Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/36796
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-36509
dc.description.abstract
Purpose: The aim of this study was to assess the mid-term clinical outcome of the ankle joint after total knee arthroplasty (TKA) in high-grade valgus osteoarthritis.
Methods: In this case–control study, n=36 patients with a preoperative mechanical tibiofemoral angle (mTFA)≥15° who underwent TKA between December 2002 and December 2012 were included. The control group (mTFA<15°) of n=60 patients was created using case matching. Radiological [mechanical tibiofemoral angle (mTFA) and ankle joint orientation to the ground (G-AJLO)] and clinical parameters [Foot Function Index (FFI), Knee Society Score, Forgotten Joint Score,
and Range of Motion (ROM)] were analysed. The mean follow-up time was 59 months (IQR [56, 62]).
Results: The degree of correcting the mTFA by TKA signifcantly correlated with the postoperative FFI (R=0.95, p<0.05), although the knee and ankle joint lines were corrected to neutral orientations. A cut-of value of 16.5° [AUC 0.912 (0.85–0.975 95% CI), sensitivity=0.8, specifcity=0.895] was calculated, above which the odds ratio (OR) for developing ankle symptoms increased vastly [OR 34.0 (9.10–127.02 95% CI)]. ROM restrictions of the subtalar joint displayed a strong sig nifcant correlation with the FFI (R=0.74, p<0.05), demonstrating that decreased ROM of the subtalar joint was associated with aggravated outcomes of the ankle joint.
Conclusions: In this study, higher degrees of leg axis correction in TKA were associated with increased postoperative ankle symptoms. When TKA is performed in excessive valgus knee osteoarthritis, surgeons should be aware that this might trigger the onset or progression of ankle symptoms, particularly in cases of a stif subtalar joint.
Level of evidence III.
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Total knee arthroplasty
en
dc.subject
Total knee replacement
en
dc.subject
Osteoarthritis knee
en
dc.subject
Interplay knee ankle
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Correction of severe valgus osteoarthritis by total knee arthroplasty is associated with increased postoperative ankle symptoms
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00167-020-06246-4
dcterms.bibliographicCitation.journaltitle
Knee Surgery, Sports Traumatology, Arthroscopy
dcterms.bibliographicCitation.number
2
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
527
dcterms.bibliographicCitation.pageend
535
dcterms.bibliographicCitation.volume
30
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32839848
dcterms.isPartOf.issn
0942-2056
dcterms.isPartOf.eissn
1433-7347