Hindfoot may show compensatory changes in alignment following TKA in patients with knee OA
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CHARLOTTE, N.C. — Patients who undergo total knee arthroplasty for knee osteoarthritis may experience changes in alignment of the hindfoot following surgery; however, more meaningful comparisons between studies are needed, a presenter said.
“There is a variety of research literature out there that demonstrates that there is a relationship between knee malalignment and hindfoot malalignment in patients with knee osteoarthritis (OA),” Mohammed T. Azam, BS, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting. “So, the purpose of our study was to evaluate the changes in hindfoot alignment and clinical outcomes following TKA,” Azam added.
Azam and colleagues performed a systematic review of the MEDLINE, EMBASE and Cochrane Library databases to analyze the level of evidence and quality of evidence in 11 studies, which included 1,142 patients (1,358 knees). Tibio-calcaneal angle was the most common parameter used to measure hindfoot alignment (27.3% of cases).
Researchers found patients with preoperative varus knee and valgus hindfoot, patients with valgus knee and valgus hindfoot, and patients with valgus knee and varus hindfoot deformities all demonstrated improvement in hindfoot alignment following TKA. However, patients with preoperative varus knee and varus hindfoot deformities demonstrated no improvement in hindfoot alignment following TKA.
Despite limitations in levels and qualities of evidence across the 11 studies, Azam concluded, “valgus hindfoot displays changes in alignment following TKA; however, we didn’t see [improvement in alignment] in varus hindfoot and varus knee deformities,” he said “This may lead to a deleterious effect on the survivorship of the implant. Earlier intervention would indicate for a better hindfoot outcome,” he added.
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Butler JJ, et al. Alignment of the hindfoot following total knee arthroplasty: A systematic review. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22 - Sept. 25, 2021; Charlotte, N.C.
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