{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:07:32Z","timestamp":1790140052117,"version":"4.0.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Varus or valgus knee deformities influence ankle coronal alignments. The impact of Total Knee Arthroplasty (TKA) on ankle joint alignment has not been entirely illustrated. Inverse Kinematic Alignment (iKA) is a surgical philosophy that aims to restore soft tissue balance, function, and native anatomy within validated boundaries to restore restrictive native kinematics. Therefore, this study aimed to investigate the postoperative association of patient-specific alignment on the coronal alignment of the ankle in patients with varus knee deformity who underwent iKA TKA. We hypothesized that greater preoperative varus malalignments would correlate with significant postoperative ankle coronal alignment changes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective study of a prospective collected cohort assessed patients who underwent imageless navigation assisted robotic TKA using a single implant design for primary osteoarthritis between January 2022 and August 2023. Preoperative and postoperative full-length standing anteroposterior X-ray imaging was used to measure Hip-Knee-Ankle (HKA), Tibial Plafond Inclination (TPI), Talar inclination (TI), and Tibiotalar Tilt (TTT) angles. Patients were subsequently divided into groups of neutral varus)\u2009&lt;\u200910\u00b0) and severe varus (\u2265\u200910\u00b0) according to the preoperative HKA angle.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Significant changes in preoperative and postoperative HKA angles were found in the severe varus (14.5\u00b0 vs. 6.4\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) group. Changes were also significant between preoperative and postoperative TPI and TI angles in the severe varus group; however, TTT did not reach statistical significance. Delta change from pre- to postoperative HKA was significantly higher for the severe varus group (8.1\u00b0 vs. 0.8\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.019). Delta change of TPI, TI and TTT did not differ between groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Coronal knee alignment after TKA affects coronal alignment of the ankle. iKA technique in TKA for varus knee deformity preserves or minimizes substantial coronal alignment changes of the ankle joint. These findings may add to the benefits reported for patient specific alignment TKA techniques.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of evidence<\/jats:title>\n            <jats:p>III.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00402-024-05549-2","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T16:10:36Z","timestamp":1726243836000},"page":"4455-4461","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of inverse kinematic alignment total knee arthroplasty on coronal alignment of the ankle joint in patients with varus knee deformity"],"prefix":"10.1007","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-8671","authenticated-orcid":false,"given":"Ittai","family":"shichman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Hallak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itay","family":"Ashkenazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Warschwaski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviram","family":"Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimrod","family":"Snir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"5549_CR1","doi-asserted-by":"publisher","unstructured":"Wells VM, Hearn TC, McCaul KA et al (2002) Changing incidence of primary total hip arthroplasty and total knee arthroplasty for primary osteoarthritis. 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Dr. AG is a paid lecturer for Depuy. Drs. AH IS, IA and YW have not financial disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tel-Aviv Sourasky Medical Center (0120-19-TLV).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was waivered.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}