The Relationship Between Knee Arthroplasty and Foot Loading
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Michael L. Voronov, Michael S. Pinzur, Robert M. Havey, Gerard Carandang, Joseph A. Gil, William J. Hopkinson,
Foot Ankle Spec February 2012 vol. 5 no. 1 17-22
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Related thread:
Shoe Recommendation for Total Knee Replacement -
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Quote (my emphasis).
"Surgeons have questioned whether foot deformity applies abnormal loading on a knee implant. A total of 24 patients with mild knee deformity underwent a static recording of foot loading prior to and at 3 months following knee replacement. Of these patients, 13 had a preoperative varus deformity. The recorded postoperative to preoperative loading in all 6 geographic sites was decreased by an average of 10%. The largest changes were observed in the hallux and lesser toe masks, whereas the postoperative to preoperative foot pressure ratio in the metatarsal head (lateral and medial), heel, and midfoot masks was 0.94. This preliminary investigation reveals a minimal change in geographic foot loading following total knee arthroplasty in patients with mild knee deformity."
Craig is right. I have witnessed exacerbated hip pain in patients with new knees, usually over one year post-op.
Plus, in my book anyway, static foot loading in a small cohort tells us very little.
I started to look into a correlation between foot position and total knee replacements (TKR) a while back. I didn't find much.
I sat in on several TKR clinics, where weightbearing foot position was not even considered. Interestingly the tibial inter-medullary jig used for obtaining a straight knee during surgery stops at the level of the talocrural joint, although the design may have changed since I last looked.
Anecdotally (from other post-grad students in my dept who were doing research on knee and hips, mostly to do with prosthesis wear) this particular Trust had a lot of revision surgery going on because of post-op patellar pain.
I talked to another Orthopod from a different Trust a year or so ago about this. His view was that foot position made little or no difference to TKR outcomes, and that they did very little revision surgery:confused:. -
There is some pretty cool research now using instrumented total knee joint implants and tibial force transducers which can measure knee joint and tibial loads in vivo postoperatively.
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Dynamic foot function changes following total knee replacement surgery.
Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Fotoohabadi MR, Bergman NR.
Knee. 2012 Jun 4
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Influence of Conventional Post Total Knee Replacement Rehabilitation Protocol on Angles Of Flat Foot
Smisha Thomas, Vinod Babu. K, Sai Kumar. N, Vikas Kadam V.
International Journal of Physiotherapy and Research 2013;05:267-273
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Alteration Of Hindfoot Alignment After Total Knee Arthroplasty Using A Novel Hindfoot Alignment View
Yusuke Hara et al
The Journal of Arthroplasty; Available online 25 July 2014
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Clinical usefulness of hindfoot assessment for total knee arthroplasty: persistent post-operative hindfoot pain and alignment in pre-existing severe knee deformity.
Okamoto Y, Otsuki S, Jotoku T, Nakajima M, Neo M.
Knee Surg Sports Traumatol Arthrosc. 2016 Apr 7
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Effect of Pedal Deformity on Gait in a Patient With Total Knee Arthroplasty.
Wynes J, Lamm BM, Bhave A, Elmallah RK, Mont MA.
Orthopedics. 2016 Jan-Feb;39(1):e159-61. doi: 10.3928/01477447-20151218-11.
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Clinical Evaluation and Gait Characteristics before and after Total Knee Arthroplasty Based on a Portable Gait Analyzer.
Zhang HH et al
Orthop Surg. 2016 Aug;8(3):360-6. doi: 10.1111/os.12270.
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This clinical trial was just registered:
Changes in Pedographic Pattern After Knee Reconstructive Surgery (PEDKnee)
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A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankle.
Söylev GÖ, Boya H
Acta Orthop Traumatol Turc. 2016 Oct 7
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Do foot & ankle assessments assist the explanation of one year knee arthroplasty outcomes?
Gates LS et al
Osteoarthritis Cartilage. 2016 Dec 30. pii: S1063-4584(16)30491-5. doi: 10.1016/j.joca.2016.12.022.
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Pedobarographic Analysis in Total Knee Arthroplasty.
Güven M et al
J Knee Surg. 2017 Mar 10. doi: 10.1055/s-0037-1599247.
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Hindfoot alignment at one year after total knee arthroplasty.
Takenaka T et al
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Radiographic changes in coronal alignment of the ankle joint immediately after primary total knee arthroplasty for varus knee osteoarthritis
Ichiro Tonogai, Daisuke Hamada, Koichi Sairyo
The Foot and Ankle Online Journal 10 (2): 2
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Changes in hindfoot alignment after total knee arthroplasty in knee osteoarthritic patients with varus deformity.
Cho WS et al
Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3596-3604. doi: 10.1007/s00167-016-4278-8.
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Changes in Hindfoot Alignment After High or Low Tibial Osteotomy
Jun Young Choi, MD, Si Jung Song, MD, Sung Jung Kim, MD, PhD, ...
Foot & Ankle International May 15, 2018
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A Biomechanical Foot-Worn Device Improves Total Knee Arthroplasty Outcomes.
Debbi EM et al
J Arthroplasty. 2019 Jan;34(1):47-55
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Alteration of Hindfoot Axis After Total Knee Arthroplasty
HenriqueMansur et al
The Journal of Arthroplasty; 4 June 2019
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I am currently treating a patient with a rapidly progressing PTTD following a successful knee replacement. He could see the deformity getting worse every day.
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Foot loading pattern and hind foot alignment are corrected in varus knees following total knee arthroplasty: a pedobarographic analysis.
Palanisami DR et al
Knee Surg Sports Traumatol Arthrosc. 2019 Jul 16
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Calcaneal insufficiency fractures following total knee arthroplasty: Classification and clinical findings.
Yamamoto N et al
Injury. 2019 Oct 7
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Correction of severe valgus osteoarthritis by total knee arthroplasty is associated with increased postoperative ankle symptoms
Frank Graef et al
Knee Surg Sports Traumatol Arthrosc. 2020 Aug 24
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The Role of the Hindfoot in Total Knee Arthroplasty Alignment
Jessica Hooper, Joshua Rozell, Peter S Walker, Ran Schwarzkopf
Bull Hosp Jt Dis (2013). 2020;78(1):65-73.
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The use of pedobarographic analysis to evaluate movement patterns in unstable total knee arthroplasty: A proof of concept study
Alexandria Sehgal et al
Knee. 2021 Feb 17;29:110-115
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Bridging the Gap: The Influence of Foot and Ankle Pathomechanics in Total Knee Arthroplasty
Brandon H Naylor, Daniel Seidman, Giles R Scuderi
J Am Acad Orthop Surg. 2021 Apr 26
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Alignment of the hindfoot following total knee arthroplasty: A systematic review
James J Butler et al
World J Orthop. 2021 Oct 18;12(10):791-801. doi: 10.5312/wjo.v12.i10.791.
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FOOT PAIN IS COMMON, BUT FREQUENTLY IMPROVES 1 YEAR AFTER TOTAL KNEE ARTHROPLASTY
David Carmody et al
J Arthroplasty. 2022 Feb 21
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Higher revision rates in patients with preoperative contralateral pes planovalgus deformity following total knee arthroplasty
Zachary C Pearson et al
Knee Surg Sports Traumatol Arthrosc. 2023 Aug 18
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Weight-bearing line at the ankle joint level shifted laterally after total knee arthroplasty for varus knee osteoarthritis: Evaluation of the hip-to-calcaneus line
Naoya Kikuchi et al
Orthop Traumatol Surg Res. 2023 Sep 21;103690
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Increased ankle pain after total knee arthroplasty is associated with a preoperative lateralized gait and talar tilt, but not with ankle laxity or the range of motion of the subtalar joint
Marlene Rühling et al
Bone Joint J. 2023 Nov 1;105-B(11):1159-1167. doi: 10.1302/0301-620X.105B11.BJJ-2023-0419.R1.
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Increased medial talar tilt may incite ankle pain and predispose ankle osteoarthritis after correction of severity of knee varus deformity among patients undergoing bilateral total knee arthroplasty: a prospective observation
Arghya Kundu Choudhury et al
Knee Surg Relat Res. 2024 Jan 24;36(1):7.
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Eligibility for knee arthroplasty is associated with increased risk of acquired hallux valgus - a Mendelian randomized study
Zhijun Li, Zhengxuan Liu, Wei Shi, Xinyu Liang, Chunlei Xu, Kai Zhang, Hui Li & Huafeng Zhang
BMC Musculoskeletal Disorders volume 25, Article number: 311 (2024)
<
Metatarsal stress fractures in cricket fast bowlers
|
Effects of lateral column lengthening for flat foot
>
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