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

Abstract

Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.