Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study

Posted on Dec 16, 2019

New article from the MSRJ 2019 Fall issue is now up on the site! Read the abstract or click on the link below for the full article.

Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study (Click link for full PDF article)

Authors: Dominick J. Casciato, B.A.1*, Natalie A. Builes, B.A.2, Luis A. Rodriguez Anaya, DPM1, Bibi N. Singh, DPM1

Background: Total knee arthroplasty (TKA) has become the procedure of choice for those suffering from debilitating degenerative joint disease of the knee; however, new research suggests that functional changes in the rearfoot occur following the procedure to compensate for gait changes. This pilot study investigates subtalar joint (STJ) changes in cadavers with TKAs.

Methods: Four embalmed cadavers with a unilateral TKA were disarticulated at the STJ and the calcaneal articular facets were imaged. The length, width, and area of these facets ipsilateral to the joint replacement were measured using image analysis software and compared to the contralateral side.
Results: All cadavers exhibited evidence of anatomical changes at the STJ. Moreover, a transition to an anatomically unstable STJ was observed.

Conclusions: This study suggests that biomechanical compensation at the STJ may result in anatomical changes in the joint in which form of the joint follows function. Though this pathology may have developed prior to such arthroplasty, the unilateral nature of the facet changes emphasizes the need to further investigate and address gait abnormalities before and after joint replacement to optimize biomechanics in the arthritic knee.