Butler JJ, Mercer NP, Hurley ET, Azam MT, Kennedy JG. Alignment of the hindfoot following total knee arthroplasty: A systematic review. World J Orthop 2021; 12(10): 791-801 [PMID: 34754835 DOI: 10.5312/wjo.v12.i10.791]
Corresponding Author of This Article
John G Kennedy, FRCS, MCh, MD, Doctor, Department of Orthopedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, United States. john.kennedy@nyulangone.org
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Oct 18, 2021; 12(10): 791-801 Published online Oct 18, 2021. doi: 10.5312/wjo.v12.i10.791
Alignment of the hindfoot following total knee arthroplasty: A systematic review
James J Butler, Nathaniel P Mercer, Eoghan T Hurley, Mohammad T Azam, John G Kennedy
James J Butler, Eoghan T Hurley, Department of Orthopedic Surgery, Royal College Surgeons in Ireland, Dublin 18, Ireland
Nathaniel P Mercer, Eoghan T Hurley, Mohammad T Azam, John G Kennedy, Department of Orthopedic Surgery, NYU Langone Health, New York, NY 10002, United States
Author contributions: Butler JJ and Kennedy JG designed the research; Butler JJ and Hurley ET performed the research; Butler JJ, Hurley ET, Mercer NP and Azam MT wrote the paper; Kennedy JG supervised the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: John G. Kennedy has the following conflicts of interests: American Orthopaedic Foot and Ankle Society: Board or committee member; Arthroscopy Association of North America: Board or committee member; European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA); Ankle and Foot Associates (AFAS): Board or committee member; International Society for Cartilage Repair of the Ankle: Board or committee member. No other author has any conflicts of interests to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: John G Kennedy, FRCS, MCh, MD, Doctor, Department of Orthopedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, United States. john.kennedy@nyulangone.org
Received: April 4, 2021 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
ARTICLE HIGHLIGHTS
Research background
There are a variety of reports demonstrating a relationship between deformities at the knee joint and hindfoot malalignment in patients with knee osteoarthritis (OA).
Research motivation
The relationship between knee joint deformities and alterations in hindfoot alignment following total knee arthroplasty (TKA) has not been fully investigated to date.
Research objectives
To evaluate changes in alignment of the hindfoot following TKA and foot and ankle clinical outcomes in terms of subjective clinical scoring tools following surgical intervention.
Research methods
MEDLINE, EMBASE and Cochrane Library databases were systematically reviewed. Studies reporting changes in the postoperative alignment of the hindfoot following TKA were included.
Research results
Eleven studies with a total of 1142 patients (1358 knees) were included. 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, with the tibio-calcaneal angle most frequently utilised (27.3%).
Research conclusions
The hindfoot may display compensatory changes in alignment following TKA in patients with knee OA. However, the marked heterogeneity between the included studies and poor quality of evidence confounds the generation of robust conclusions from this review.
Research perspectives
Further, higher quality studies are required to determine the changes and outcomes of hindfoot alignment following TKA.
