The influence of mediolateral deformity, tibial torsion, and foot position on femorotibial load

Lindgren, Urban; Seireg, A.

doi:10.1007/bf00934152

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…We have previously reported that people with knee OA have greater tibial internal rotation compared to aged-matched controls [35], and a reduction in tibial internal rotation was observed in patients who underwent realignment of the knee following knee replacement surgery [35]. Furthermore, internal torsion and varus deformity have been associated with increased loads on the medial compartment of the knee [36]. The lack of correlation in the present study between tibia rotation and KAMs may be related to a possible restriction in tibial motion as patients may be "pushed" to the end range of motion due to years of walking in the same pattern.…”

Section: Discussionmentioning

confidence: 99%

Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

Levinger

Menz

Morrow

et al. 2013

Journal of Foot and Ankle Research

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BackgroundDynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA). Foot motion may alter the load on the medial tibiofemoral joint and hence affect the KAM. Therefore, this study aimed to investigate the relationship between tibia, rearfoot and forefoot motion in the frontal and transverse planes and the KAM in people with medial compartment knee OA.MethodMotion of the knee, tibia, rearfoot and forefoot and knee moments were evaluated in 32 patients with clinically and radiographically-confirmed OA, predominantly in the medial compartment. Pearson’s correlation coefficient was used to investigate the association between peak values of tibia, rearfoot and forefoot motion in the frontal and transverse planes and 1st peak KAM, 2nd peak KAM, and the knee adduction angular impulse (KAAI).ResultsLateral tilt of the tibia was significantly associated with increased 1st peak KAM (r = 0.60, p < 0.001), 2nd peak KAM (r = 0.67, p = 0.001) and KAAI (r = 0.82, p = 0.001). Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004). Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = −0.44, p = 0.01) and KAAI (r = −0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01). Significant negative correlations were found between peak forefoot eversion relative to the rearfoot and 2nd peak KAM (r = −0.53, p = 0.002) and KAAI (r = −0.51, p = 0.003) and between peak forefoot inversion and 2nd peak KAM (r = −0.54, p = 0.001) and KAAI (r = −0.48, p = 0.005).ConclusionIncreased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation. These findings have implications for the design of load-modifying interventions in people with knee OA.

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Section: Discussionmentioning

confidence: 99%

Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

Levinger

Menz

Morrow

et al. 2013

Journal of Foot and Ankle Research

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“…This indicated a small internal tibial torsion of less than 20 o might be biomechanically beneficial to people with moderate KOA. However, since none of our subjects had excessive internal tibial torsion, it cannot be ruled out that higher internal tibial torsion might increase the medial compartment load [26]. Also, tibial torsion was strongly associated with foot progression angle in the adult population [27].…”

Section: Plos Onementioning

confidence: 80%

Knee joint loadings are related to tibial torsional alignments in people with radiographic medial knee osteoarthritis

et al. 2021

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Torsional malalignment was detected in subjects with medial knee osteoarthritis (KOA) but few studies have reported the effect of torsional deformity on knee joint loads during walking. Therefore, this study examined the relationships between lower limb torsional alignments and knee joint loads during gait in people with symptomatic medial KOA using cross-sectional study design. Lower limb alignments including tibial torsion, tibiofemoral rotation and varus/valgus alignments in standing were measured by EOS low-dose bi-planar x-ray system in 47 subjects with mild or moderate KOA. The external knee adduction moment (KAM), flexion moment (KFM) and the KAM index which was defined as (KAM/ (KAM+KFM)*100) during walking were analyzed using a motion analysis system so as to estimate the knee loads. Results revealed externaltibial torsion was positively associated with KAM in subjects with moderate KOA (r = 0.59, p = 0.02) but not in subjects with mild KOA. On the contrary, significant association was found between knee varus/valgus alignment and KAM in the mild KOA group (r = 0.58, p<0.001) and a sign of association in the moderate KOA group (r = 0.47, p = 0.08). We concluded tibial torsion and knee varus/valgus mal-alignments would be associated with joint loading in subjects with moderate medial KOA during walking. Radiographic severity might need to be considered when using gait modification as a rehabilitation strategy for this condition.

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“…Recent research on cartilage forces and associations between variations in anatomy around the hip and leg alignment might better explain why cartilage in lateral OA deteriorates more rapidly in specific patients. 11,[14][15][16][17][18][19][20][21][22][23][24] Deformity analysis will help find the patient in which a valgus leg deformity is caused by a femoral deformity. Paley 25 describes a comprehensive system of measurements of bones and joint line angles, and defines that a femoral valgus deformity is present when the so-called mLDFA (mechanical lateral distal femoral angle) is < 88 degrees.…”

Section: Wylie Et Al (2016)mentioning

confidence: 99%

Correction of Femoral Valgus Deformity

2017

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In the past two decades, the insights in the causes and development of valgus leg deformities as well as the options for treatment with corrective osteotomies have dramatically changed. New definitions for deformity analysis and planning for corrections have better defined the patients suitable for femoral valgus deformity corrections. Biomechanical research on new osteotomy methods and stability of plate fixation have provided scientific background for the development of improved surgical techniques that are more accurate, safer, and provide for quicker rehabilitation and bone healing. This article provides an overview of the basic principles behind the correction of femoral valgus deformity. Both the analysis and planning of femoral valgus deformity correction as well as the results of systematic clinical reviews are provided. The current recommended surgical technique of biplanar medial closing-wedge supracondylar osteotomy is explained, and the first clinical results are reported. Finally, the authors describe some of the future directions and needs for treatment optimization of patients with femoral valgus deformity.

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The influence of mediolateral deformity, tibial torsion, and foot position on femorotibial load

Cited by 13 publications

References 8 publications

Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

Knee joint loadings are related to tibial torsional alignments in people with radiographic medial knee osteoarthritis

Correction of Femoral Valgus Deformity

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