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BioMed Research International
Volume 2017, Article ID 4051706, 7 pages
Research Article

Correlation in the Coronal Angle between Knee and Hindfoot Was Observed in Patients with Rheumatoid Arthritis Unless Talocrural Joint Was Destroyed

1Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
2Department of the Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
3Department of Clinical Immunology and Rheumatology, Kyoto University Graduate School of Medicine, Kyoto, Japan

Correspondence should be addressed to Hiromu Ito;

Received 14 March 2017; Revised 26 August 2017; Accepted 26 September 2017; Published 23 October 2017

Academic Editor: Nobuo Kanazawa

Copyright © 2017 Kohei Nishitani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of this study is to investigate the compensatory correlation between knee and hindfoot in patients with rheumatoid arthritis (RA). This cross-sectional study included 218 patients (407 lower extremities). Radiographs of the hindfoot and full-length posteroanterior hip-to-calcaneus standing radiographs were evaluated. The destruction of the hindfoot was evaluated using the Larsen grading system. The coronal angular deformity of the knee and hindfoot was evaluated by the femorotibial angle (FTA) and the angle between the tibial shaft and the entire hindfoot (tibiohindfoot angle, THFA). The correlation between FTA and THFA was determined by Pearson’s coefficient. For all patients, FTA correlated to THFA ( = 0.28, ). The correlation was observed as long as the talocrural joint was preserved (Larsen grade ≤ 2), even if the subtalar joint had been destroyed (Larsen grade ≥ 3). However, the correlation was not observed when the talocrural joint was destroyed (Larsen grade ≥ 3, = −0.02, ). The pain in the hindfoot did not correlate with FTA or THFA. In conclusion, a compensatory deformity of the hindfoot against the deformity of the knee was observed in RA, and the correlation was lost when talocrural joint was destroyed.