Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Abstract

BackgroundTo examine the association of radiographic frontal plane knee alignment with three-dimensional foot posture in patients with medial knee osteoarthritis (OA).MethodsParticipants in orthopedic clinics with Kellgren/Lawrence (K/L) grade ≥1 (88 patients and 88 knees; age, 61–91 years; 65.9% female) were enrolled. An anteroposterior radiographic view was used to assess the anatomical axis angle (AAA) after subtracting a sex-specific correction factor. The three-dimensional foot posture was also evaluated.ResultsMultiple regression analyses showed that increased corrected AAA (i.e., valgus direction) was independently associated with a decrease in the hallux valgus angle (regression coefficient: −0.40 per degree, 95% confidence interval [CI]: −0.72, −0.09; P = 0.013) and increase in the pronation angle of the calcaneus relative to floor (regression coefficient: 0.33 per degree, 95% CI: 0.10, 0.56; P = 0.005) adjusted for age, sex, and body mass index. The relationship between the corrected AAA and hallux valgus angle strengthened (regression coefficient: −0.60 per degree, 95% CI: −1.08, −0.13; P = 0.014) in varus-aligned knees examined separately (63 knees). The other foot postures (navicular height, navicular height/foot length, and rearfoot angle) were not significantly associated with corrected AAA.ConclusionsRadiographic frontal plane knee alignment was associated with hallux valgus angle and calcaneus angle relative to the floor in patients with medial knee OA, particularly in varus-aligned knees. These results indicate a connection between altered frontal knee alignment and foot posture, which may be helpful in understanding the pathogenesis of altered foot posture observed in patients with knee OA.

Interaction between low back pain and knee pain contributes to disability level in individuals with knee osteoarthritis: a cross-sectional study

“…OA severity in the tibiofemoral joint was assessed by an experienced examiner (HI). We previously reported excellent intra-rater (k: 0.876; 95% confidence interval [CI]: 0.829 to 0.924) and inter-rater (k: 0.845; 95% CI: 0.793 to 0.897) reliability scores 14,15 . The anatomical axis angle (AAA) with sex-specific correction 16 was assessed in the anteroposterior short view in the weight-bearing position in accordance with a previously described method 14 .…”

A prospective study of the muscle strength and reaction time of the quadriceps, hamstring, and gastrocnemius muscles in patients with plantar fasciitis

“…Lloyd & Buchanan reported that the co-contraction of the quadriceps and hamstring muscles directly supports the valgus/varus moments at the knee joint. [32] The valgus and varus moments of the knee joint can impact foot pronation and supination, respectively, [33][34][35] which may increase plantar fascia stress owing to increased pressure in the forefoot and hindfoot. [20] In the PF patients in the present study, the hamstring and quadriceps muscles showed a delayed reaction time, with greater pressure in the forefoot and hindfoot and hindfoot valgus on pedobarography, despite normal feet on plain radiographs, compared to the normal control group.…”

Between-side Comparisons of Iliotibial Band Flexibility and the Tibial Torsion Angle in Subjects with an Asymmetric Hallux Valgus Angle

“…Earlier studies explored whether lower extremity alignment affected HV. 2,13,14 We sought a link between asymmetric HVAs and lower extremity alignment. Iliotibial band flexibility differed significantly between the two sides.…”

“…The body forms a connected mechanical chain. 2,3,13,16 HV causes not only foot problems, but also general malalignment and muscle strength imbalance in the lower extremities. 2,3,4 The entire exercise chain requires study, i.e., not only the knee joint, but also the hip.…”