Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and
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ORIGINAL PAPER
Change in the weight-bearing line ratio of the ankle joint and ankle joint line orientation after knee arthroplasty and high tibial osteotomy in patients with genu varum deformity Jae Gyoon Kim 1 & Dong Hun Suh 1 & Gi Won Choi 1 & Bong Mo Koo 1 & Sang-Gyun Kim 1 Received: 8 July 2020 / Accepted: 1 September 2020 # SICOT aisbl 2020
Abstract Purpose Several studies reported that excessive correction of severe genu varum deformity with total knee arthroplasty or high tibial osteotomy (HTO) could result in ankle joint pain and osteoarthritis progression. However, few studies have evaluated the change in the weight-bearing-line (WBL) ratio of the ankle joint after knee arthroplasty or HTO in patients with genu varum deformities. This study aimed to investigate the change in the WBL ratio of the ankle joint and ankle joint line orientation after knee arthroplasty or HTO in patients with genu varum deformities. Methods We retrospectively evaluated 40 patients (mean age, 69.9 ± 8.0 years) with genu varum deformities of > 5° and underwent knee arthroplasty or HTO. Three radiologic parameters, including (1) the hip-knee-ankle (HKA) angle, (2) WBL ratio of the ankle joint, and (3) ankle joint line orientation relative to the ground (AJLO-G), were assessed using pre-operative and post-operative orthoradiographs. A paired t test was used to evaluate post-operative changes in the three parameters. Correlations between the change in HKA angle and that in the WBL ratio of the ankle joint and AJLO-G were analyzed. Results The mean HKA angle significantly decreased post-operatively (10.6° ± 5.3° to 1.1° ± 3.4°; P < 0.001). The WBL ratio of the ankle joint increased from 35.8% ± 15.2% to 53.0% ± 17.4% (P < 0.001), with a lateral shift of the mechanical axis. The AJLO-G decreased with valgization of ankle orientation (7.8° ± 4.8° to 0.4° ± 3.8°; P < 0.001). The change in the HKA angle was significantly correlated with that in the AJLO-G (correlation coefficient = 0.716; P < 0.001) but not with the change in the WBL ratio of the ankle joint. Conclusion Knee arthroplasty and HTO corrected the genu varum deformity, which influenced the lateral shift of the WBL of the ankle joint and valgization of the ankle joint line orientation. Keywords Knee . Ankle . Arthroplasty . High tibial osteotomy . Weight-bearing line ratio . Joint line orientation Jae Gyoon Kim and Dong Hun Suh contributed equally to this work. Level of evidence: IV, retrospective cohort study Jae Gyoon Kim and Dong Hun Suh are co-first authors. * Sang-Gyun Kim [email protected] Jae Gyoon Kim [email protected] Dong Hun Suh [email protected] Gi Won Choi [email protected] Bong Mo Koo [email protected] 1
Department of Orthopedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeongki-do 15355, Republic of Korea
Introduction Total knee arthroplasty and high tibial osteotomy (HTO) have shown good clinical results in restoring lower extremity alignment, reducing pain, and improving knee function in patients with moderate-to-s
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