ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022
Osteotomies around the knee lead to corresponding frontal realignment of the ankle.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 13 citations in OpenAlex.
- Ankle Alignment Changes After High Tibial Osteotomy due to Valgus-Shaped Distal Tibia.Cartilage · 2026Article
- Assessment and quantification of ipsilateral and contralateral ankle joint alignment changes after unilateral total knee arthroplasty for knee osteoarthritis with varus deformity: a retrospective cohort study.Knee surgery & related research · 2025Article
- Knee osteotomies significantly influence coronal ankle alignment: A radiographic analysis.Journal of experimental orthopaedics · 2025Article
- Optimal Sequence of Corrective Surgeries for Concomitant Valgus Knee and Rigid Pes Planus Deformities: The Knee-First Approach.Arthroplasty today · 2023Article
- Osteotomies around the knee alter alignment of the ankle and hindfoot: a systematic review of biomechanical and clinical studies.EFORT open reviews · 2023Article
- The gap height in open wedge high tibial osteotomy is not affected by the starting point of the osteotomy.BMC musculoskeletal disorders · 2023Article
- Increasing grades of frontal deformities in knee osteoarthritis are not associated with ligamentous ankle instabilities.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- The Relationship between Frontal, Axial Leg Alignment, and Ankle Joint Line Orientation-a Radiographic Analysis of Healthy Subjects.Orthopaedic surgery · 2023Article
- Iatrogenic ischiofemoral impingement due to high tibial osteotomy with overvalgization: a case report.Journal of medical case reports · 2022Article
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Authors and funding
5 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionDespite the fact that osteotomies around the knee represent well-established treatment options for the redistribution of loads and forces within and around the knee joint, unforeseen effects of these osteotomies on the ankle are still to be better understood. It was therefore the aim of this study to determine the influence of osteotomies around the knee on the coronal alignment of the ankle. We hypothesize that osteotomies around the knee for correction of genu varum or valgum lead to a change of the ankle orientation in the frontal plane by valgisation or varisation. MATERIALS AND
methodsLong-leg standing radiographs of 154 consecutive patients undergoing valgisation or varisation osteotomy around the knee in 2017 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy site. The hip knee ankle angle (HKA), the mechanical lateral distal femur angle (mLDFA), the mechanical medial proximal tibia angle (mMPTA) and five angles around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann-Whitney test.
resultsOne hundred fifty-four patients (96 males, 58 females) underwent osteotomies around the knee for coronal realignment. The mean age was 51 ± 11 years. Correction osteotomies consisted of 73 HTO, 54 DFOs, and 27 double level osteotomies. Of all osteotomies, 118 were for valgisation and 36 for varisation. For valgisation osteotomies, the mean HKA changed from 5.8° ± 2.9° preoperatively to - 0.9° ± 2.5° postoperatively, whereas the mMPTA changed from 85.9° ± 2.7° to 90.7° ± 3.1° and the malleolar-horizontal-orientation-angle (MHA) changed from 16.4° ± 4.2° to 10.9° ± 4.2°. For varisation osteotomies, the mean HKA changed from - 4.3° ± 3.7° to 1.1° ± 2.2° postoperatively, whereas the mLDFA changed from 85.7° ± 2.2° to 89.3° ± 2.3° and the MHA changed from 8.8° ± 5.1° to 11.2° ± 3.2°.
conclusionOsteotomies around the knee for correction of coronal limb alignment not only lead to lateralization or medialization of the weight-bearing line at the knee but also lead to a coronal reorientation of the ankle. This can be measured at the ankle using the MHA. When planning an osteotomy around the knee for correction of genu varum or valgum, the ankle should also be appreciated-especially in patients with preexisting deformities, ligament instabilities, or joint degeneration around the ankle.
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