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Changes in coronal alignment of the ankle joint after high tibial osteotomy

  • Gi Won Choi
  • Jae Hyuk Yang
  • Jung Ho Park
  • Ho Hyun Yun
  • Yong In Lee
  • Jin Eon Chae
  • Jung Ro Yoon
Knee

Abstract

Purpose

The purpose of this study was to investigate changes in coronal alignment of the ankle joint after HTO. Our hypothesis was that ankle joint orientation may become more parallel or less parallel to the ground after HTO, and this change may affect ankle symptoms.

Methods

Eighty-six knees were retrospectively analysed after HTO for varus osteoarthritis. Preoperative and follow-up whole-leg radiographs were taken. The hip–knee–ankle (HKA) angle and medial proximal tibial angle (MPTA) were measured to evaluate coronal alignment of the knee. Tibial plafond inclination (TPI), talar inclination (TI), talar tilt (TT), and lateral distal tibial angle (LDTA) were measured to evaluate coronal alignment of the ankle. Patients were divided into two groups: those who exhibited a decrease in the absolute value of TPI and TI after HTO (group A) and those who exhibited an increase in the absolute value of TPI or TI after HTO (group B). Clinical outcomes of the knee and ankle were evaluated pre- and postoperatively.

Results

Mean TPI and TI changed from 6.9° ± 3.6° and 8.0° ± 3.8° to 2.8° ± 3.1° and 3.9° ± 3.0° in group A (P < 0.001 for both) and from −1.3° ± 3.7° and 0.6° ± 4.5° to −6.0° ± 4.2° and −4.6° ± 5.9° in group B (P = 0.018 for both). VAS for ankle pain did not change significantly after HTO (n.s.) in group A, whereas those of group B increased significantly after HTO (P = 0.014).

Conclusion

Ankle joint orientation becomes more parallel or less parallel to the ground after HTO. Smaller preoperative HKA and LDTA result in a more valgus ankle joint orientation after HTO. Ankle symptoms were affected by coronal alignment changes of the ankle after HTO.

Level of evidence

III.

Keywords

High tibial osteotomy Alignment Knee Ankle 

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  • Gi Won Choi
    • 1
  • Jae Hyuk Yang
    • 2
  • Jung Ho Park
    • 1
  • Ho Hyun Yun
    • 2
  • Yong In Lee
    • 2
  • Jin Eon Chae
    • 2
  • Jung Ro Yoon
    • 2
  1. 1.Department of Orthopaedic SurgeryKorea University College of Medicine, Ansan HospitalAnsan-si, Gyeonggi-doSouth Korea
  2. 2.Department of Orthopaedic SurgeryVeterans Health Service Medical CenterSeoulSouth Korea

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