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Alignment of the hindfoot following total knee arthroplasty: A systematic review

BACKGROUND: There appears to be a close relationship between deformities at the knee joint and at the hindfoot in patients with knee osteoarthritis (OA). Despite this intrinsic link, there is a dearth of studies investigating alterations in hindfoot alignment following total knee arthroplasty (TKA)...

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Autores principales: Butler, James J, Mercer, Nathaniel P, Hurley, Eoghan T, Azam, Mohammad T, Kennedy, John G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554349/
https://www.ncbi.nlm.nih.gov/pubmed/34754835
http://dx.doi.org/10.5312/wjo.v12.i10.791
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author Butler, James J
Mercer, Nathaniel P
Hurley, Eoghan T
Azam, Mohammad T
Kennedy, John G
author_facet Butler, James J
Mercer, Nathaniel P
Hurley, Eoghan T
Azam, Mohammad T
Kennedy, John G
author_sort Butler, James J
collection PubMed
description BACKGROUND: There appears to be a close relationship between deformities at the knee joint and at the hindfoot in patients with knee osteoarthritis (OA). Despite this intrinsic link, there is a dearth of studies investigating alterations in hindfoot alignment following total knee arthroplasty (TKA) in patients with knee OA. AIM: To evaluate changes in alignment of the hindfoot following TKA, foot and ankle clinical outcomes in terms of subjective clinical scoring tools following surgical intervention, and to analyse the level of evidence (LOE) and quality of evidence (QOE) of the included studies. METHODS: MEDLINE, EMBASE and Cochrane Library databases were systematically reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting changes in the postoperative alignment of the hindfoot following TKA were included. The level and QOE were recorded and assessed. RESULTS: Eleven studies with a total of 1142 patients (1358 knees) met the inclusion/ exclusion criteria. Six studies were of LOE II and 5 studies were of LOE III. Patients with preoperative varus knee deformity and valgus hindfoot deformity demonstrated improvement in hindfoot alignment post TKA. Patients with preoperative varus knee deformity and varus hindfoot deformity demonstrated no improvement in hindfoot alignment following TKA. Twelve different radiographic parameters were used to measure the alignment of the hindfoot across the included studies, with the tibio-calcaneal angle most frequently utilised (27.3%). CONCLUSION: This systematic review demonstrated that the hindfoot may display compensatory changes in alignment following TKA in patients with knee OA. However, the marked heterogeneity between the included studies and poor QOE limits any meaningful cross sectional comparisons between studies. Further, well designed studies are necessary to determine the changes and outcomes of hindfoot alignment following TKA.
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spelling pubmed-85543492021-11-08 Alignment of the hindfoot following total knee arthroplasty: A systematic review Butler, James J Mercer, Nathaniel P Hurley, Eoghan T Azam, Mohammad T Kennedy, John G World J Orthop Systematic Reviews BACKGROUND: There appears to be a close relationship between deformities at the knee joint and at the hindfoot in patients with knee osteoarthritis (OA). Despite this intrinsic link, there is a dearth of studies investigating alterations in hindfoot alignment following total knee arthroplasty (TKA) in patients with knee OA. AIM: To evaluate changes in alignment of the hindfoot following TKA, foot and ankle clinical outcomes in terms of subjective clinical scoring tools following surgical intervention, and to analyse the level of evidence (LOE) and quality of evidence (QOE) of the included studies. METHODS: MEDLINE, EMBASE and Cochrane Library databases were systematically reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting changes in the postoperative alignment of the hindfoot following TKA were included. The level and QOE were recorded and assessed. RESULTS: Eleven studies with a total of 1142 patients (1358 knees) met the inclusion/ exclusion criteria. Six studies were of LOE II and 5 studies were of LOE III. Patients with preoperative varus knee deformity and valgus hindfoot deformity demonstrated improvement in hindfoot alignment post TKA. Patients with preoperative varus knee deformity and varus hindfoot deformity demonstrated no improvement in hindfoot alignment following TKA. Twelve different radiographic parameters were used to measure the alignment of the hindfoot across the included studies, with the tibio-calcaneal angle most frequently utilised (27.3%). CONCLUSION: This systematic review demonstrated that the hindfoot may display compensatory changes in alignment following TKA in patients with knee OA. However, the marked heterogeneity between the included studies and poor QOE limits any meaningful cross sectional comparisons between studies. Further, well designed studies are necessary to determine the changes and outcomes of hindfoot alignment following TKA. Baishideng Publishing Group Inc 2021-10-18 /pmc/articles/PMC8554349/ /pubmed/34754835 http://dx.doi.org/10.5312/wjo.v12.i10.791 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Systematic Reviews
Butler, James J
Mercer, Nathaniel P
Hurley, Eoghan T
Azam, Mohammad T
Kennedy, John G
Alignment of the hindfoot following total knee arthroplasty: A systematic review
title Alignment of the hindfoot following total knee arthroplasty: A systematic review
title_full Alignment of the hindfoot following total knee arthroplasty: A systematic review
title_fullStr Alignment of the hindfoot following total knee arthroplasty: A systematic review
title_full_unstemmed Alignment of the hindfoot following total knee arthroplasty: A systematic review
title_short Alignment of the hindfoot following total knee arthroplasty: A systematic review
title_sort alignment of the hindfoot following total knee arthroplasty: a systematic review
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554349/
https://www.ncbi.nlm.nih.gov/pubmed/34754835
http://dx.doi.org/10.5312/wjo.v12.i10.791
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