Dynamic foot function changes following total knee replacement surgery

作者：Levinger Pazit^*; Menz Hylton B; Morrow Adam D; Bartlett John R; Feller Julian A; Fotoohabadi Mohammad R; Bergman Neil R

来源：Knee, 2012, 19(6): 880-885.

DOI：10.1016/j.knee.2012.05.002

• Knee replacement
• Knee alignment
• Foot posture
• Foot function kinematics

Background: Individuals with knee osteoarthritis (OA) have flatter/more pronated feet than those without OA, but it is unclear whether altered foot posture and function are a cause or consequence of knee OA. The purpose of this study was to examine whether changes in foot posture and function occur after realignment of the knee following total knee replacement (TKR). %26lt;br%26gt;Materials and methods: Nineteen patients with predominantly medial compartment knee OA were tested prior to and 12 months after TKR. The Foot Posture Index (FPI) and Arch Index (AI) were measured as well as motion of the tibia, rearfoot and forefoot using a 3D motion analysis system incorporating a multisegment foot model. %26lt;br%26gt;Results: There were no significant changes in FPI or AI following TKR, however gait analysis revealed significant increases in tibial external rotation (-18.7 +/- 7.0 degrees vs -22.5 +/- 8.7 degrees, p=0.002). tibial transverse plane range of motion (-9.1 +/- 4.6 degrees vs -11.4 +/- 6.1 degrees, p=0.0028) and rearfoot range of motion in the frontal plane (8.6 +/- 2.6 degrees vs 10.4 +/- 2.7 degrees, p=0.002), and a decrease in rearfoot transverse plane range of motion (8.7 +/- 5.3 degrees vs 5.9 +/- 4.1 degrees, p=0.038) following the procedure. %26lt;br%26gt;Conclusions: TKR produces no change in static foot posture, but results in significant changes in rearfoot kinematics during gait. These findings suggest that rearfoot motion compensates for changes in the alignment of the knee, highlighting the ability of the foot to accommodate for proximal skeletal malalignment.

• 出版日期2012-12