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全膝关节置换术后膝内翻型骨关节炎患者踝关节的中期临床及影像学变化

Mid-Term Clinical and Radiological Changes in the Ankle Joint in Varus Knee Osteoarthritis Following Total Knee Arthroplasty.

作者信息

Nazlıgül Ali Said, Doğan Metin, Duran İsmail, Moya-Angeler Joaquín, Akkaya Mustafa

机构信息

Department of Orthopedics and Traumatology, Sincan Training and Research Hospital, 06949 Ankara, Turkey.

Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, 06800 Ankara, Turkey.

出版信息

J Clin Med. 2024 Aug 10;13(16):4700. doi: 10.3390/jcm13164700.

Abstract

In patients with varus knee osteoarthritis, compensatory changes occur in the foot and ankle joints to compensate for the varus deformity of the knee. The aim of the study was to investigate the changes in the ankle of patients whose knee alignment was corrected with total knee arthroplasty (TKA) and to explore the clinical implications of these findings. : In this retrospective observational study, we analyzed 204 knees of 179 patients who had regular follow-ups out of 431 patients who underwent TKA for varus knee osteoarthritis between January 2019 and July 2021. Patient demographics, body mass index, follow-up time, and radiographs were studied. The hip-knee-ankle (HKA) angle, joint line convergence angle (JLCA), talar tilt (TT) angle, ground talar dome (GT) angle, ground tibia plafond (GP) angle, and the American Orthopaedic Foot & Ankle Society (AOFAS) score were assessed preoperatively and at the last follow-up. : A total of 204 knees of 179 patients with a mean follow-up time of 32.50 ± 6.68 months were evaluated. It was found that the change in the HKA had a positive effect on the AOFAS score and a negative effect on the TT, GT, and GP angles. While the clinical score improved in 82 patients, it worsened in 8 patients. The age difference between the groups whose AOFAS score improved and worsened was statistically significant. : The correction of the varus malalignment in the knee was shown to also improve the compensatory valgus in the foot and ankle over the mid-term, with a statistically significant improvement in the patients' clinical ankle scores.

摘要

在膝内翻骨关节炎患者中,足踝关节会发生代偿性变化以补偿膝关节的内翻畸形。本研究的目的是调查全膝关节置换术(TKA)矫正膝关节力线后患者踝关节的变化,并探讨这些发现的临床意义。:在这项回顾性观察研究中,我们分析了2019年1月至2021年7月期间因膝内翻骨关节炎接受TKA的431例患者中179例有定期随访的患者的204个膝关节。研究了患者的人口统计学资料、体重指数、随访时间和X线片。术前及末次随访时评估髋-膝-踝(HKA)角、关节线汇聚角(JLCA)、距骨倾斜(TT)角、地面距骨穹顶(GT)角、地面胫骨平台(GP)角以及美国矫形足踝协会(AOFAS)评分。:共评估了179例患者的204个膝关节,平均随访时间为32.50±6.68个月。发现HKA的变化对AOFAS评分有积极影响,对TT、GT和GP角有消极影响。82例患者临床评分改善,8例患者临床评分恶化。AOFAS评分改善组和恶化组之间的年龄差异具有统计学意义。:膝关节内翻畸形的矫正显示在中期也改善了足踝关节的代偿性外翻,患者的临床踝关节评分有统计学意义的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a7/11354923/52f2d7f0a4ca/jcm-13-04700-g001.jpg

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