Alteration of Hindfoot Alignment After Total Knee Arthroplasty Using a Novel Hindfoot Alignment View

This study examined the coronal alignment of the hindfoot in varus osteoarthritis of the knee before and after total knee arthroplasty (TKA) in 100 legs using a novel imaging method. We categorized the preoperative hindfoot alignment into varus (30 legs) and valgus (70 legs) groups; imaging of the hindfoot was conducted preoperatively and postoperatively, and the varus–valgus angle (VVA) was measured as the hindfoot alignment. The femorotibial angle improved significantly after TKA. We found that the VVA improved significantly after TKA in the hindfoot valgus group (P < 0.001), but not in the varus group (P = 0.554), and we speculate that the hindfoot alignment in the valgus group improved as a result of a residual compensatory capacity in the hindfoot.