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
Processing time: 193 Days and 1.9 Hours
There are a variety of reports demonstrating a relationship between deformities at the knee joint and hindfoot malalignment in patients with knee osteoarthritis (OA).
The relationship between knee joint deformities and alterations in hindfoot alignment following total knee arthroplasty (TKA) has not been fully investigated to date.
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.
MEDLINE, EMBASE and Cochrane Library databases were systematically reviewed. Studies reporting changes in the postoperative alignment of the hindfoot following TKA were included.
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%).
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.
Further, higher quality studies are required to determine the changes and outcomes of hindfoot alignment following TKA.