Foot loading following knee arthroplasty

NewsBot · Aug 22, 2025

Risk Factors for Foot and Ankle Pain After Total Knee Arthroplasty and the Role of Subtalar Joint Motion Capacity
Mirac Kadir Turhan, Tayfun Bacaksiz, Ihsan Akan, Mehmet Maden, Cem Ozcan, Cemal Kazimoglu
J Am Acad Orthop Surg. 2025 Jul 30

Introduction: Total knee arthroplasty (TKA) restores the mechanical axis of the lower extremity, which is impaired due to gonarthrosis. Foot and ankle pain observed after TKA is not uncommon, and the exact cause has not been determined. This study aims to assess the role of the movement capacity of the subtalar joint and the clinical and radiological risk factors for foot and ankle pain after TKA.

Methods: This study included 184 patients who underwent TKA due to primary varus gonarthrosis. Patients were evaluated clinically and radiologically before and after surgery. Lower extremity mechanical axis, talar-tilt angle, foot ground-talar dome angle, heel alignment ratio, heel alignment angle, heel alignment distance, and postoperative changes were the radiological angles measured. The Oxford Knee Score, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score, visual analog scale score, and ankle and subtalar joint range of motion examinations were used clinically. Patients were grouped as those whose American Orthopaedic Foot and Ankle Society scores did not worsen after surgery (group 1) and those whose scores worsened (group 2).

Results: The group 1 included 142 patients (77.2%) and group 2 included 42 patients (22.8%). The mean preoperative knee varus degree of group 1 was 11.49 ± 3.45, and that of group 2 was 14.26 ± 4.21 (P < 0.001). The mean body mass index was 26.67 ± 2.31 for group 1 and 29.47 ± 3.14 for group 2 (P < 0.001). Although no important difference was found between the groups in preoperative ankle motion capacity (P = 0.086), subtalar joint motion was found to be markedly limited in group 2 (P < 0.001).

Conclusion: High preoperative knee varus degree and body mass index values, especially diminished preoperative subtalar joint motion capacity together with these values, are risk factors for postoperative foot and ankle pain after TKA.
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NewsBot · Sep 12, 2025

Patients with varus hindfoot deformity show decreased knee and foot clinical scores after total knee arthroplasty
Yoshihiro Wanezaki et al
Knee. 2025 Aug 28:57:200-208

Objective: Evaluating hindfoot alignment using the tibiocalcaneal angle (TCA) is important for understanding the lower limb load axis before and after total knee arthroplasty (TKA). However, no previous studies have investigated the relationship between TCA classification and clinical outcomes after TKA in Japanese patients, including those with TCA varus and valgus deformities. This study aimed to examine the relationship between TCA and knee and foot outcomes following TKA.

Methods: Patients who underwent primary TKA for osteoarthritis at our university and affiliated hospitals between October 2020 and October 2021 were prospectively evaluated. Based on preoperative TCA, patients were categorized into varus (<0°), intermediate (0-8°), and valgus (>8°) groups. Preoperative, 6-month, and 1-year postoperative clinical outcomes were assessed using the new Knee Society Scoring System (KSS, 2011), Oxford Knee Score (OKS), and the 5-item SAFE-Q (SQ). Statistical analysis was performed using the Kruskal-Wallis test, Dunn's multiple comparison test, and logistic regression analysis.

Results: Both the KSS and OKS were significantly lower in the varus group at 6 and 12 months (p < 0.05). At 6 months, the varus group had significantly lower scores on social life functions, shoe-related issues, and overall health (p < 0.05). Logistic regression analysis showed that TCA varus was an independent factor that reduced KSS, OKS, SQ, social life function, and overall health 1-year postoperatively (odds ratios: 2.73, 2.95, 1.90, 2.23; p < 0.05).

Conclusion: Overall, our findings suggest that the patients with varus hindfoot deformity show decreases in knee and foot clinical scores following total knee arthroplasty.
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NewsBot · Dec 6, 2025

Foot posture as a biomechanical outcome measure following total knee arthroplasty in individuals with severe knee osteoarthritis
Saidan Shetty et al
Sci Rep 2025 Dec 5.

Total knee arthroplasty (TKA) is commonly performed to relieve pain and improve knee function in individuals with severe knee osteoarthritis (OA). Abnormal foot mechanics can influence overall biomechanics and affect post-surgical outcomes. This study aimed to evaluate foot posture as a biomechanical outcome before and after TKA and to explore its relationship with pain, functional performance, and quadriceps (Q) angle. Seventy-seven individuals with knee OA who underwent TKA, and 77 healthy controls were assessed. Foot posture was measured using the Foot Posture Index (FPI), pain using the Numerical Pain Rating Scale (NPRS), and function using the Lower Extremity Functional Scale (LEFS), Timed Up and Go (TUG), and 6-Minute Walk Test (6MWT). Q-angle was assessed as a structural alignment measure. Evaluations were conducted preoperatively and at 6 weeks, 3, 6, and 12 months postoperatively. Preoperative FPI was significantly higher in the OA group than controls (1.52 ± 2.5 vs. 0.70 ± 2.2; p = 0.03). At 6 months post-TKA, FPI remained higher than controls (p = 0.03), but the difference from controls was no longer statistically significant at 12 months. A weak correlation existed between FPI and pain (p < 0.05); no correlation was found with functional or alignment outcomes. Foot posture provides limited longitudinal insight; broader biomechanical assessment is advised.
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Foot loading following knee arthroplasty

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Foot loading following knee arthroplasty

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer

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Share This Page

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