Foot posture in people with medial compartment knee osteoarthritis

Abstract

BackgroundFoot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb. This study compared foot posture in people with and without medial compartment knee osteoarthritis (OA) using a range of clinical foot measures. The reliability of the foot measures was also assessed.MethodsThe foot posture of 32 patients with clinically and radiographically-confirmed OA predominantly in the medial compartment of the knee and 28 asymptomatic age-matched healthy controls was investigated using the foot posture index (FPI), vertical navicular height and drop, and the arch index. Independent t tests and effect size (Cohen's d) were used to investigate the differences between the groups in the foot posture measurements.ResultsSignificant differences were found between the control and the knee OA groups in relation to the FPI (1.35 ± 1.43 vs. 2.46 ± 2.18, p = 0.02; d = 0.61, medium effect size), navicular drop (0.02 ± 0.01 vs. 0.03 ± 0.01, p = 0.01; d = 1.02, large effect size) and the arch index (0.22 ± 0.04 vs. 0.26 ± 0.04, p = 0.04; d = 1.02, large effect size). No significant difference was found for vertical navicular height (0.24 ± 0.03 vs. 0.23 ± 0.03, p = 0.54; d = 0.04, negligible effect size).ConclusionPeople with medial compartment knee OA exhibit a more pronated foot type compared to controls. It is therefore recommended that the assessment of patients with knee OA in clinical practice should include simple foot measures, and that the potential influence of foot structure and function on the efficacy of foot orthoses in the management of medial compartment knee OA be further investigated.

Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus and cavus feet

“…However, this difference was due to greater eversion excursion during initial contact rather than during midstance or propulsion as in our study. Other studies that used different reference positions to ours report inconsistent results, with two finding greater peak eversion in pes planus [3,21] compared to three that found no significant differences [8,26,27].…”

Exercise, Gait Retraining, Footwear and Insoles for Knee Osteoarthritis

“…Research has shown that medial knee OA is associated with a flattened (pronated) foot posture [50]. Furthermore, recent data has linked the pronated foot type to a greater frequency of knee pain and medial tibiofemoral cartilage damage in older people [51].…”

Efecto de los posteos mediales de retropié sobre la posición de calcáneo y tibia en estática

“…Las ortesis plantares constituyen un elemento terapéutico ampliamente utilizado para intentar corregir esta desalineación de los segmentos que conforman el miembro inferior 2,3,[5][6][7][8][11][12][13][14][15][16] . Su uso se basa en el control de la movilidad subtalar tanto a nivel del rango articular como a nivel de la velocidad del movimiento 5 .…”

“…Varios investigadores han descubierto en sus estudios 14,15 que con el uso de ortesis plantares hay diferencias significativas en los movimientos que conforman los segmentos del miembro inferior y explicarían así la mejoría en cuanto a la sintomatología dolorosa. Pero por otro lado, existen otras investigaciones 3,7,16 que no han demostrado que la disminución de la sintomatología dolorosa se deba a una corrección de la alineación de los segmentos que conforman el miembro inferior dado que el uso de las ortesis plantares no produce movimientos significativos en dichos segmentos.…”

“…Para la medición del movimiento de los segmentos del miembro inferior se han utilizado diversos métodos: marcado de los ejes sobre la piel y su posterior medición mediante goniometría 3,4,10,11,16 , realización de radiografías con y sin corrección utilizando ortesis plantares y su posterior goniometría 12 , colocación de marcadores reflectantes sobre la piel y el análisis de su movimiento mediante cámaras de vídeo y software de análisis del movimiento [7][8][9][10]15 , así como la colocación de marcadores óseos bajo anestesia local y la medición de su movimiento mediante software específico 2 . Polhemus Patriot ® es un dispositivo con sensores electromagnéticos utilizado por diversos autores [18][19][20][21] en el campo de la medicina para la medición del movimiento de los segmentos corporales en columna lumbar, rodilla, pie o incluso para la medición de la estabilidad corporal.…”