Published online Oct 18, 2021. doi: 10.5312/wjo.v12.i10.791
Peer-review started: April 4, 2021
First decision: June 7, 2021
Revised: July 21, 2021
Accepted: August 4, 2021
Article in press: August 4, 2021
Published online: October 18, 2021
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.
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.
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.
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%).
This systematic review demonstrated that the hindfoot may display compen
Core Tip: This current systematic review has found that correction of deformities at the knee joint following total knee arthroplasty typically resulted in improved changes in the alignment of the hindfoot. However, the poor quality of evidence together with the marked heterogeneity between the included studies, underscores the need for further higher quality studies.