Pathomechanics of Structural Foot Deformities

Tiberio, David

doi:10.1093/ptj/68.12.1840

Cited by 156 publications

(109 citation statements)

References 11 publications

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“…The concern is that patients undergoing TKA, who also present with a stiff subtalar joint, may have subsequent, post-TKA foot/ankle pain or disability resulting from the inability of the subtalar joint to reorient itself after knee realignment (Fig. 7) [16]. Patients undergoing TKA who also have stiff subtalar joints, on preoperative examination, should be counseled that their hindfoot symptoms might worsen after TKA.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Knee and Hindfoot Deformities in Advanced Knee OA: Compensatory Hindfoot Alignment and Where It Occurs

Norton

Callaghan

Amendola

et al. 2015

Clinical Orthopaedics &Amp; Related Research

129

163

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Background Many patients undergoing TKA have both knee and ankle pathology, and it seems likely that some compensatory changes occur at each joint in response to deformity at the other. However, it is not fully understood how the foot and ankle compensate for a given varus or valgus deformity of the knee. Questions/purposes (1) What is the compensatory hindfoot alignment in patients with end-stage osteoarthritis who undergo total knee arthroplasty (TKA)? (2) Where in the hindfoot does the compensation occur? Methods Between January 1, 2005, and December 31, 2009, one surgeon (JJC) obtained full-length radiographs on all patients undergoing primary TKA (N = 518) as part of routine practice; patients were analyzed for the current study and after meeting inclusion criteria, a total of 401 knees in 324 patients were reviewed for this analysis. Preoperative standing long-leg AP radiographs and Saltzman hindfoot views were analyzed for the following measurements: mechanical axis angle, Saltzman hindfoot alignment and angle, anatomic lateral distal tibial angle, and the ankle line convergence angle. Statistical analysis included two-tailed Pearson correlations and linear regression models. Intraobserver and interobserver intraclass coefficients for the measurements considered were evaluated and all were excellent (in excess of 0.8).Results As the mechanical axis angle becomes either more varus or valgus, the hindfoot will subsequently orient in more valgus or varus position, respectively. For every degree increase in the valgus mechanical axis angle, the hindfoot shifts into varus by À0.43°(95% confidence interval [CI], À0.76°to À0.1°; r = À0.302, p = 0.0012). For every degree increase in the varus mechanical axis angle, the hindfoot shifts into valgus by À0.49°(95% CI, À0.67°to À0.31°; r = À0.347, p \ 0.0001). In addition, the subtalar joint had a strong positive correlation (r = 0.848, r 2 = 0.72, p \ 0.0001) with the Saltzman hindfoot angle, whereas the anatomic lateral distal tibial One of the authors certifies that he (AA) has or may receive payments or benefits, during the study period an amount USD 100,000 to USD 1,000,000 from Arthrex (Naples, FL, USA), an amount less than USD 10,000 from Arthrosurface (Franklin, MA, USA), and an amount USD 100,000 to USD 1,000,000 from MTP Solutions (Logan, UT, USA). One of the authors certifies that he (JJC) has or may receive payments or benefits, during the study period an amount more than USD 1,000,001 from DePuy (Warsaw, IN, USA) and an amount less than USD 10,000 from Lippincott Williams & Wilkins (Riverwoods, IL, USA). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each aut...

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Section: Discussionmentioning

confidence: 99%

Correlation of Knee and Hindfoot Deformities in Advanced Knee OA: Compensatory Hindfoot Alignment and Where It Occurs

Norton

Callaghan

Amendola

et al. 2015

Clinical Orthopaedics &Amp; Related Research

129

163

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“…The term ligamentous creep refers to stretching and decreased strength in ligaments caused by continuous stresses on them, which in turn causes instability of the forefoot during weightbearing. 15 Numerous reasons for such structural foot changes can be postulated: 1) biomechanical deformity (pes planus), 2) a hormonal cause of excessive mass (eg, increased height seen in subjects with excessive body mass), 3) an excess of adipose tissue, 4) increased bone formation and subperiosteal expansion resulting from increased plantar forces and pressures experienced during gait, and 5) a combination of these factors.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric Foot Structure of Peripubescent Children with Excessive versus Normal Body Mass

Morrison

Durward

Watt

et al. 2007

Journal of the American Podiatric Medical Association

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Background: A variety of musculoskeletal problems have been associated with excessive body mass in children, including structural foot problems. Methods: Two hundred children aged 9 to 12 years were recruited to evaluate the effect of body mass on foot structure. Three reliable anthropometric measures were recorded: foot length, forefoot width, and navicular height. Results: Following independent sample t test analysis of the data, significant differences were found for the three anthropometric variables when children with normal body mass were compared with those with excessive body mass. The research indicates that foot length and width increase with body mass, whereas navicular height drops. Conclusions: Excessive body mass affects the discrete anthropometric structure of the peripubescent foot. With the growing concern about childhood obesity, further research is essential to develop a comprehensive understanding of the issues identified and to quantify the findings presented here. (J Am Podiatr Med Assoc 97(5): 366–370, 2007)

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“…It has been extensively debated in literature for managing pediatric disorders through controlling the foot structure of the children [31][32][33][34]. The essence of foot orthoses is the emphasis of the importance of dynamic inter-relationships of foot joints during gait [15,23,[35][36][37]. The biomechanical principles in which foot orthoses work remain contentious [38][39][40][41].…”

Section: Foot Orthotic Interventionmentioning

confidence: 99%

“…The biomechanical principles in which foot orthoses work remain contentious [38][39][40][41]. However, previous systematic reviews revealed favourable therapeutic outcomes when foot orthoses are prescribed to manage abnormal foot pronation and its associated pathological conditions [16][17][18]36] with high levels of efficacy [19,20] and patient's satisfaction [21].…”

Section: Foot Orthotic Interventionmentioning

confidence: 99%

The treatability of “growing pains” in children - a mini review

Yip¹,

Shu-Yan²

2016

Pediatr Dimensions

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Aim: Growing pains in children is not an uncommon condition. Relative local overuse, reduction of bone strength, reduction of pain threshold, hypovitaminosis D and abnormal foot postures have all been found to be associated with the condition. Yet the etiology of the condition has not been completely determined. At present, there is no standard treatment protocol of the condition. As the growing pains in children tend to disappear with age, many health care practitioners opt not to treat the condition or dismiss the patient on the ground that he or she would get better with time. The present mini-review aims at reviewing the current treatment approaches and recommendation. Methods and materials:A manual search in the PubMed has been made, using the keywords growing pains in children, treatment, orthoses and vitamin D, for treatments of growing pains in children.Results: A search of literature reveals a well-implemented muscle stretching program as the first line treatment. In spite of the rather equivocal findings from the numerous studies regarding the efficacy of foot orthoses, their success in reducing pain and symptoms related to growing pains cannot be denied. The prescription of foot orthotics is clinically advocated. Also, supplementation of vitamin D3 is suggested for children with hypovitaminosis D, as it has been found that the majority of children with growing pains have a low serum 25-hydroxyvitamin D level. Conclusions:Children with growing pains should be assessed for their serum vitamin D level and their foot postures. Supplementation of vitamin D3 and foot orthoses may improve the signs and symptoms of patients, when indicated.

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Pathomechanics of Structural Foot Deformities

Cited by 156 publications

References 11 publications

Correlation of Knee and Hindfoot Deformities in Advanced Knee OA: Compensatory Hindfoot Alignment and Where It Occurs

Correlation of Knee and Hindfoot Deformities in Advanced Knee OA: Compensatory Hindfoot Alignment and Where It Occurs

Anthropometric Foot Structure of Peripubescent Children with Excessive versus Normal Body Mass

The treatability of “growing pains” in children - a mini review

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