Kai Xie1, Xu Jiang1, Xuequan Han1, Songtao Ai2, Xinhua Qu3, Mengning Yan1. 1. Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract
BACKGROUND: The association between knee malalignment and ankle degeneration has not been well established. This study aimed at determining whether knee malalignment and compensatory ankle morphology to knee malalignment are associated with the development and progression of ankle osteoarthritis (OA) in patients with end-stage knee OA. METHODS: We retrospectively reviewed 96 patients (106 knees) who underwent total knee arthroplasty. The progression of ankle OA, knee alignment, and ankle morphology were evaluated based on digital radiographs. Alignment deformity of the lower extremity was evaluated with hip-knee-ankle angle and medial proximal tibial angle (MPTA). Ankle morphology was evaluated by the lateral distal tibial angle, talar tilt, tibial plafond inclination angle, and ankle joint line orientation angle. RESULTS: The incidence of radiological ankle OA was observed in 39 of 106 cases. The MPTA (odds ratio = 0.72, P = .0009) and hip-knee-ankle angle (odds ratio = 1.13, P = .0169) were significantly associated with ankle OA. Among patients with tibial varus deformity, 26 of 49 had ankle OA. Among patients with neutral tibial alignment, 13 of 57 had radiological findings of ankle OA. MPTA was the only parameter associated with the progression of ankle OA. No association was observed between compensatory change in ankle morphology and the severity of ankle OA. CONCLUSION: Tibial varus deformity is associated with the development and progression of ankle OA; however, it is unclear whether it causes ankle OA. Due to the high incidence of ankle OA in total knee arthroplasty patients, it is reasonable to consider routine evaluation of the ankle.
BACKGROUND: The association between knee malalignment and ankle degeneration has not been well established. This study aimed at determining whether knee malalignment and compensatory ankle morphology to knee malalignment are associated with the development and progression of ankle osteoarthritis (OA) in patients with end-stage knee OA. METHODS: We retrospectively reviewed 96 patients (106 knees) who underwent total knee arthroplasty. The progression of ankle OA, knee alignment, and ankle morphology were evaluated based on digital radiographs. Alignment deformity of the lower extremity was evaluated with hip-knee-ankle angle and medial proximal tibial angle (MPTA). Ankle morphology was evaluated by the lateral distal tibial angle, talar tilt, tibial plafond inclination angle, and ankle joint line orientation angle. RESULTS: The incidence of radiological ankle OA was observed in 39 of 106 cases. The MPTA (odds ratio = 0.72, P = .0009) and hip-knee-ankle angle (odds ratio = 1.13, P = .0169) were significantly associated with ankle OA. Among patients with tibial varus deformity, 26 of 49 had ankle OA. Among patients with neutral tibial alignment, 13 of 57 had radiological findings of ankle OA. MPTA was the only parameter associated with the progression of ankle OA. No association was observed between compensatory change in ankle morphology and the severity of ankle OA. CONCLUSION:Tibial varus deformity is associated with the development and progression of ankle OA; however, it is unclear whether it causes ankle OA. Due to the high incidence of ankle OA in total knee arthroplasty patients, it is reasonable to consider routine evaluation of the ankle.
Authors: Xin Zhou; Qi Liu; Tao Liang; Ping Xu; Yang Liu; Shijie Fu; Guoyou Wang; Lei Zhang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2021-06-15