Ipsilateral and contralateral foot pronation in those with knee osteoarthritis

NewsBot · Mar 24, 2016

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Ipsilateral and contralateral foot pronation affect lower limb and trunk biomechanics of individuals with knee osteoarthritis during gait
Renan A. Resende et al
Clinical Biomechanics; Article in Press

Highlights
?Lateral wedges increase shank rotation in knee osteoarthritis individuals
?Lateral wedges affect trunk kinematics in individuals with knee osteoarthritis
?Lateral wedges on the healthy side increase knee osteoarthritis adduction moments
?Increased foot pronation should not be overlooked in knee osteoarthritis individuals
?Knee osteoarthritis individuals report less comfort walking with lateral wedges
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Background
Lateral wedges have been suggested for the treatment of individuals with knee osteoarthritis, but it may have undesirable effects on the biomechanics of gait through increased foot pronation. This study investigated the effects of increased unilateral foot pronation on the biomechanics of individuals with knee osteoarthritis during gait.

Methods
Biomechanical data of twenty individuals with knee osteoarthritis were collected while they walked in three conditions: i) flat sandals; ii) wedged sandal on the knee osteoarthritis limb and flat sandal on the healthy limb; iii) flat sandal on the osteoarthritis and wedged sandal on the healthy limb. Knee pain and comfort were evaluated. Principal Component Analysis followed by ANOVA were implemented to identify differences between conditions.

Findings
The wedged sandal on the osteoarthritis limb increased rearfoot eversion (p < 0.001;ES = 0.79); increased shank rotation range of motion (p < 0.001;ES = 0.70); reduced knee internal rotation moment (p < 0.001;ES = 0.83); reduced hip internal rotation moment (p = 0.001;ES = 0.66); increased ipsilateral trunk lean (p = 0.031;ES = 0.47); and increased trunk rotation range of motion (p = 0.001;ES = 0.69). Walking with the wedged sandal on the healthy limb increased hip (p = 0.003;ES = 0.61) and knee (p = 0.002;ES = 0.63) adduction moments. Individuals reported greater comfort walking with the flat sandals (p = 0.004;ES = 0.55).

Interpretation
Increased unilateral foot pronation of the knee osteoarthritis and healthy limbs causes lower limb and trunk mechanical changes that may overload the knee and the lower back, such as increased knee adduction moment, shank rotation and trunk lateral lean. Foot motion of both lower limbs should be evaluated and care must be taken when suggesting lateral wedges for individuals with knee osteoarthritis.
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Admin2 · Mar 24, 2016

Related Topics:
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Medial and lateral foot loading and its effect on knee joint loading
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How do you do lateral wedging for medial knee osteoarthritis
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NewsBot · Sep 11, 2022

Evaluation of hindfoot and knee alignment by the hip-to-calcaneus view in patients with knee osteoarthritis and healthy individuals
Yoshihiro Wanezaki et al
Knee. 2022 Sep 7;38:184-192

Background: Hip-to-calcaneus (HC) view is a whole-leg standing view that can visualize the hindfoot in detail. The aim of this study was to investigate the reliability and validity of tibiocalcaneal angle in HC view (H-TCA) by comparing it with that in long axial view (L-TCA). We also verified whether periarticular knee alignment parameters, measured conventionally in whole-leg standing radiography, could be measured in HC view.

Method: Sixty healthy volunteers and 61 patients with medial knee osteoarthritis were included. H-TCA was measured by two examiners in the healthy group, and intra-class correlation coefficients (ICCs) were evaluated. H-TCA and L-TCA were then measured in the healthy and osteoarthritis groups and correlated. Finally, we measured hip-knee-ankle angle, mechanical axis deviation ratio, mechanical lateral distal femoral angle, medial proximal tibial angle, and joint-line convergence angle in HC view and conventional whole-leg standing radiography to evaluate statistical differences and correlations.

Results: The intra-observer and inter-observer ICCs were 0.86 and 0.76, respectively. Correlation coefficients (r) between H-TCA and L-TCA were r = 0.87 in healthy group and r = 0.81 in osteoarthritis group, indicating a strong positive correlation in both groups. There was no significant difference in periarticular knee alignment parameters between HC view and conventional whole-leg radiography.

Conclusions: Hindfoot evaluation in HC view showed high intra-observer and inter-observer reliabilities and strong positive correlation with TCA in long axial view. By using HC view before knee surgery, such as total knee arthroplasty, other necessary alignments can be evaluated simultaneously.
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