論文

査読有り 筆頭著者 責任著者
2017年8月

Clinical usefulness of hindfoot assessment for total knee arthroplasty: persistent post-operative hindfoot pain and alignment in pre-existing severe knee deformity

KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
  • Yoshinori Okamoto
  • ,
  • Shuhei Otsuki
  • ,
  • Tsuyoshi Jotoku
  • ,
  • Mikio Nakajima
  • ,
  • Masashi Neo

25
8
開始ページ
2632
終了ページ
2639
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00167-016-4122-1
出版者・発行元
SPRINGER

The purpose of this study was to compare the hindfoot alignment and symptoms in patients with pre-existing moderate and severe knee deformities after total knee arthroplasty (TKA).
Eighty knees of 75 patients who underwent TKA for varus osteoarthritis were enrolled retrospectively and evaluated the following pre-operatively and at 2 years post-operatively: the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (pain and function scores), calcaneal pitch, and naviculocuboid overlap as an indicator of hindfoot alignment. The knees were divided into two groups according to the pre-operative hip-knee-ankle angle defined as the angle between the mechanical axis of the femur and the tibia: group M with genu varus of ae<currency>6A degrees, and group S with varus > 6A degrees.
The pain (p = 0.03) and function (p = 0.02) scores improved in group M; however, in group S, these measures did not change. The differences between the groups were not significant concerning the pre-operative calcaneal pitch and naviculocuboid overlap. The post-operative pitch (p = 0.03) and the overlap (p = 0.04) in group M was significantly greater and less than those in group S, respectively. Although the pitch (p < 0.01) and the overlap (p = 0.03) increased in group M, these did not change in group S. Post-operative hindfoot pain and valgus remained in patients in group S.
For pre-existing moderate knee deformities, a relationship was observed between post-operative knee alignment and compensatory hindfoot alignment, whereas patients with severe deformities experienced persistent post-operative hindfoot pain and valgus alignment. It was concluded that evaluations and managements of residual symptoms after TKA including the hindfoot are important. These findings are clinically relevant that perioperative evaluation of the hindfoot should be required in knee surgery. To help improve the outcomes of TKA, clinicians may consider perioperative intervention in the insole and/or physical therapy of the foot and ankle.
Therapeutic study, Level III.

リンク情報
DOI
https://doi.org/10.1007/s00167-016-4122-1
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/27056693
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000406189500046&DestApp=WOS_CPL
ID情報
  • DOI : 10.1007/s00167-016-4122-1
  • ISSN : 0942-2056
  • eISSN : 1433-7347
  • PubMed ID : 27056693
  • Web of Science ID : WOS:000406189500046

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