Varus deformity in the proximal tibia and immediate postoperative varus alignment result in varus progression in limb alignment in the ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-01-03

AUTHORS

Yuichi Kuroda, Koji Takayama, Shinya Hayashi, Shingo Hashimoto, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda, Tomoyuki Matsumoto

ABSTRACT

PurposeThe aim of this study was to examine and evaluate the factors associated with changes in limb alignment 10 years after total knee arthroplasty (TKA). The hypothesis was that bone morphology and immediate postoperative alignment could be correlated with long-term post-operative alignment changes following TKA.MethodsThis study retrospectively analysed 136 consecutive primary TKA cases for varus deformity, performed from 2006 to 2008, that could be followed for at least 10 years postoperatively. Anteroposterior long-leg weight-bearing radiographs were obtained within 1 month and at least 10 years after surgery. The hip–knee–ankle (HKA) angle immediately after surgery was compared with that 10 years later; factors correlating with the change in HKA angle (δHKA) were evaluated.ResultsThe mean HKA angles were significantly different between immediate and long-term postoperative assessments (0.1° ± 1.9° vs. 1.2° ± 2.9°, p < 0.001). Furthermore, a significant difference was observed in the outlier ratio (> 3° deviation from the 0° of HKA angle) (10% vs. 24%, p = 0.002). δHKA strongly correlated with a higher preoperative tibial plateau tip-to-proximal tibial shaft (TPTPS) angle, higher postoperative HKA angle, lateral distal femoral angle, and lower postoperative medial proximal tibial angle.ConclusionVarus deformity in the proximal part of the tibia, immediate postoperative varus alignment, and varus position of the femoral and tibial components may lead to varus progression in limb alignment in the long term, even 10 years after TKA; the surgeon should, therefore, weigh the risks of leaving a varus alignment during surgery. Moreover, if the preoperative TPTPS angle is high, the alignment may become varus after TKA, even in patients who have acquired neutral alignment.Level of evidenceIV. More... »

PAGES

3287-3293

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-019-05841-4

DOI

http://dx.doi.org/10.1007/s00167-019-05841-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1123812361

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31900497


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    "description": "PurposeThe aim of this study was to examine and evaluate the factors associated with changes in limb alignment 10\u00a0years after total knee arthroplasty (TKA). The hypothesis was that bone morphology and immediate postoperative alignment could be correlated with long-term post-operative alignment changes following TKA.MethodsThis study retrospectively analysed 136 consecutive primary TKA cases for varus deformity, performed from 2006 to 2008, that could be followed for at least 10\u00a0years postoperatively. Anteroposterior long-leg weight-bearing radiographs were obtained within 1\u00a0month and at least 10\u00a0years after surgery. The hip\u2013knee\u2013ankle (HKA) angle immediately after surgery was compared with that 10\u00a0years later; factors correlating with the change in HKA angle (\u03b4HKA) were evaluated.ResultsThe mean HKA angles were significantly different between immediate and long-term postoperative assessments (0.1\u00b0\u2009\u00b1\u20091.9\u00b0 vs. 1.2\u00b0\u2009\u00b1\u20092.9\u00b0, p\u2009<\u20090.001). Furthermore, a significant difference was observed in the outlier ratio (>\u20093\u00b0 deviation from the 0\u00b0 of HKA angle) (10% vs. 24%, p\u2009=\u20090.002). \u03b4HKA strongly correlated with a higher preoperative tibial plateau tip-to-proximal tibial shaft (TPTPS) angle, higher postoperative HKA angle, lateral distal femoral angle, and lower postoperative medial proximal tibial angle.ConclusionVarus deformity in the proximal part of the tibia, immediate postoperative varus alignment, and varus position of the femoral and tibial components may lead to varus progression in limb alignment in the long term, even 10\u00a0years after TKA; the surgeon should, therefore, weigh the risks of leaving a varus alignment during surgery. Moreover, if the preoperative TPTPS angle is high, the alignment may become varus after TKA, even in patients who have acquired neutral alignment.Level of evidenceIV.", 
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30 schema:description PurposeThe aim of this study was to examine and evaluate the factors associated with changes in limb alignment 10 years after total knee arthroplasty (TKA). The hypothesis was that bone morphology and immediate postoperative alignment could be correlated with long-term post-operative alignment changes following TKA.MethodsThis study retrospectively analysed 136 consecutive primary TKA cases for varus deformity, performed from 2006 to 2008, that could be followed for at least 10 years postoperatively. Anteroposterior long-leg weight-bearing radiographs were obtained within 1 month and at least 10 years after surgery. The hip–knee–ankle (HKA) angle immediately after surgery was compared with that 10 years later; factors correlating with the change in HKA angle (δHKA) were evaluated.ResultsThe mean HKA angles were significantly different between immediate and long-term postoperative assessments (0.1° ± 1.9° vs. 1.2° ± 2.9°, p < 0.001). Furthermore, a significant difference was observed in the outlier ratio (> 3° deviation from the 0° of HKA angle) (10% vs. 24%, p = 0.002). δHKA strongly correlated with a higher preoperative tibial plateau tip-to-proximal tibial shaft (TPTPS) angle, higher postoperative HKA angle, lateral distal femoral angle, and lower postoperative medial proximal tibial angle.ConclusionVarus deformity in the proximal part of the tibia, immediate postoperative varus alignment, and varus position of the femoral and tibial components may lead to varus progression in limb alignment in the long term, even 10 years after TKA; the surgeon should, therefore, weigh the risks of leaving a varus alignment during surgery. Moreover, if the preoperative TPTPS angle is high, the alignment may become varus after TKA, even in patients who have acquired neutral alignment.Level of evidenceIV.
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37 schema:keywords Anteroposterior long-leg weight-bearing radiographs
38 ConclusionVarus deformity
39 HKA angle
40 MethodsThis study
41 ResultsThe
42 TKA cases
43 TPTPS angle
44 aim
45 alignment
46 alignment 10
47 alignment changes
48 alignment results
49 angle
50 ankle
51 arthroplasty
52 assessment
53 bone morphology
54 cases
55 changes
56 components
57 consecutive primary TKA cases
58 deformity
59 differences
60 distal femoral angle
61 factors
62 femoral angle
63 higher postoperative HKA angle
64 higher preoperative tibial plateau tip
65 hypothesis
66 immediate postoperative alignment
67 immediate postoperative varus alignment
68 immediate postoperative varus alignment result
69 knee arthroplasty
70 lateral distal femoral angle
71 limb alignment
72 limb alignment 10
73 long term
74 long-leg weight-bearing radiographs
75 long-term post-operative alignment changes
76 long-term postoperative assessment
77 medial proximal tibial angle
78 months
79 morphology
80 neutral alignment
81 outlier ratio
82 part
83 patients
84 plateau tip
85 position
86 post-operative alignment changes
87 postoperative HKA angle
88 postoperative alignment
89 postoperative assessment
90 postoperative medial proximal tibial angle
91 postoperative varus alignment
92 postoperative varus alignment result
93 preoperative TPTPS angle
94 preoperative tibial plateau tip
95 primary TKA cases
96 progression
97 proximal part
98 proximal tibia
99 proximal tibial angle
100 proximal tibial shaft (TPTPS) angle
101 radiographs
102 ratio
103 results
104 risk
105 shaft angle
106 significant differences
107 study
108 surgeons
109 surgery
110 terms
111 tibia
112 tibial angle
113 tibial component
114 tibial plateau tip
115 tibial shaft (TPTPS) angle
116 tip
117 total knee arthroplasty
118 varus alignment
119 varus alignment result
120 varus deformity
121 varus position
122 varus progression
123 weight-bearing radiographs
124 years
125 ΔHKA
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