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Foot loading following knee arthroplasty

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Feb 8, 2012.

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  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    The Relationship Between Knee Arthroplasty and Foot Loading
    Michael L. Voronov, Michael S. Pinzur, Robert M. Havey, Gerard Carandang, Joseph A. Gil, William J. Hopkinson,
    Foot Ankle Spec February 2012 vol. 5 no. 1 17-22
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    That may well be the case, but surely following a knee arthroplasty they are now more active --> walk more --> greater loading on foot!
     
  4. davidh

    davidh Podiatry Arena Veteran

    Quote (my emphasis).
    "Surgeons have questioned whether foot deformity applies abnormal loading on a knee implant. A total of 24 patients with mild knee deformity underwent a static recording of foot loading prior to and at 3 months following knee replacement. Of these patients, 13 had a preoperative varus deformity. The recorded postoperative to preoperative loading in all 6 geographic sites was decreased by an average of 10%. The largest changes were observed in the hallux and lesser toe masks, whereas the postoperative to preoperative foot pressure ratio in the metatarsal head (lateral and medial), heel, and midfoot masks was 0.94. This preliminary investigation reveals a minimal change in geographic foot loading following total knee arthroplasty in patients with mild knee deformity."

    Craig is right. I have witnessed exacerbated hip pain in patients with new knees, usually over one year post-op.
    Plus, in my book anyway, static foot loading in a small cohort tells us very little.

    I started to look into a correlation between foot position and total knee replacements (TKR) a while back. I didn't find much.
    I sat in on several TKR clinics, where weightbearing foot position was not even considered. Interestingly the tibial inter-medullary jig used for obtaining a straight knee during surgery stops at the level of the talocrural joint, although the design may have changed since I last looked.
    Anecdotally (from other post-grad students in my dept who were doing research on knee and hips, mostly to do with prosthesis wear) this particular Trust had a lot of revision surgery going on because of post-op patellar pain.

    I talked to another Orthopod from a different Trust a year or so ago about this. His view was that foot position made little or no difference to TKR outcomes, and that they did very little revision surgery:confused:.
     
  5. There is some pretty cool research now using instrumented total knee joint implants and tibial force transducers which can measure knee joint and tibial loads in vivo postoperatively.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965044/

     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Dynamic foot function changes following total knee replacement surgery.
    Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Fotoohabadi MR, Bergman NR.
    Knee. 2012 Jun 4
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Influence of Conventional Post Total Knee Replacement Rehabilitation Protocol on Angles Of Flat Foot
    Smisha Thomas, Vinod Babu. K, Sai Kumar. N, Vikas Kadam V.
    International Journal of Physiotherapy and Research 2013;05:267-273
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Alteration Of Hindfoot Alignment After Total Knee Arthroplasty Using A Novel Hindfoot Alignment View
    Yusuke Hara et al
    The Journal of Arthroplasty; Available online 25 July 2014
     
  9. NewsBot

    NewsBot The Admin that posts the news.

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    1
    Clinical usefulness of hindfoot assessment for total knee arthroplasty: persistent post-operative hindfoot pain and alignment in pre-existing severe knee deformity.
    Okamoto Y, Otsuki S, Jotoku T, Nakajima M, Neo M.
    Knee Surg Sports Traumatol Arthrosc. 2016 Apr 7
     
  10. NewsBot

    NewsBot The Admin that posts the news.

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    1
    Effect of Pedal Deformity on Gait in a Patient With Total Knee Arthroplasty.
    Wynes J, Lamm BM, Bhave A, Elmallah RK, Mont MA.
    Orthopedics. 2016 Jan-Feb;39(1):e159-61. doi: 10.3928/01477447-20151218-11.
     
  11. NewsBot

    NewsBot The Admin that posts the news.

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    Clinical Evaluation and Gait Characteristics before and after Total Knee Arthroplasty Based on a Portable Gait Analyzer.
    Zhang HH et al
    Orthop Surg. 2016 Aug;8(3):360-6. doi: 10.1111/os.12270.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

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    This clinical trial was just registered:
    Changes in Pedographic Pattern After Knee Reconstructive Surgery (PEDKnee)
    .
     
  13. NewsBot

    NewsBot The Admin that posts the news.

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    1
    A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankle.
    Söylev GÖ, Boya H
    Acta Orthop Traumatol Turc. 2016 Oct 7
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Do foot & ankle assessments assist the explanation of one year knee arthroplasty outcomes?
    Gates LS et al
    Osteoarthritis Cartilage. 2016 Dec 30. pii: S1063-4584(16)30491-5. doi: 10.1016/j.joca.2016.12.022.
     
  15. NewsBot

    NewsBot The Admin that posts the news.

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    Pedobarographic Analysis in Total Knee Arthroplasty.
    Güven M et al
    J Knee Surg. 2017 Mar 10. doi: 10.1055/s-0037-1599247.
     
  16. NewsBot

    NewsBot The Admin that posts the news.

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    Hindfoot alignment at one year after total knee arthroplasty.
    Takenaka T et al
    Knee Surg Sports Traumatol Arthrosc. 2016 Aug;24(8):2442-6.
     
  17. NewsBot

    NewsBot The Admin that posts the news.

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    Radiographic changes in coronal alignment of the ankle joint immediately after primary total knee arthroplasty for varus knee osteoarthritis
    Ichiro Tonogai, Daisuke Hamada, Koichi Sairyo
    The Foot and Ankle Online Journal 10 (2): 2
     
  18. NewsBot

    NewsBot The Admin that posts the news.

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    Changes in hindfoot alignment after total knee arthroplasty in knee osteoarthritic patients with varus deformity.
    Cho WS et al
    Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3596-3604. doi: 10.1007/s00167-016-4278-8.
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Changes in Hindfoot Alignment After High or Low Tibial Osteotomy
    Jun Young Choi, MD, Si Jung Song, MD, Sung Jung Kim, MD, PhD, ...
    Foot & Ankle International May 15, 2018
     
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