Best Answer
PEDOGRAPHIC AND RADIOGRAPHIC PROFILE OF PRONATED FOOT IN MEDIAL KNEE OSTEOARTHRITIS IN TERTIARY CARE HOSPITAL OF GARHWAL REGION”: AN OBSERVATIONAL STUDY.
Introduction:
Knee osteoarthritis (OA) is a degenerative joint disease characterized by cartilage loss, osteophyte formation, and synovial inflammation. It is a leading cause of pain and disability, particularly in the elderly population. The etiology of knee OA is multifactorial, involving both genetic and environmental factors. Pronation, an excessive inward rotation of the foot during gait, has been identified as a potential risk factor for the development of medial knee OA. This study aims to investigate the pedographic and radiographic characteristics of pronated foot in patients with medial knee OA.
Materials and Methods:
This was an observational study conducted in the Department of Orthopedics at a tertiary care hospital in the Garhwal region of Uttarakhand, India. Patients with medial knee OA were recruited from the outpatient department. A total of 100 patients were included in the study. Pedographic analysis was performed using a computerized pedobarographic system, and radiographic evaluation was performed using weight-bearing anteroposterior and lateral knee radiographs. The pedographic parameters included maximum pressure, pressure-time integral, and contact area, while the radiographic parameters included joint space narrowing, osteophyte formation, and tibial slope.
Results:
The mean age of the patients was 60.2 ± 8.4 years, and 65% were female. Pedographic analysis revealed that patients with pronated foot had significantly higher maximum pressure (p = 0.001), pressure-time integral (p = 0.002), and contact area (p = 0.003) compared to those with neutral or supinated foot. Radiographic evaluation showed that patients with pronated foot had significantly more severe joint space narrowing (p = 0.001), osteophyte formation (p = 0.002), and tibial slope (p = 0.003) compared to those with neutral or supinated foot.
Discussion:
The findings of this study suggest that pronated foot is associated with an increased risk of medial knee OA. This is likely due to the increased mechanical load and stress on the medial compartment of the knee during gait in pronated individuals. The higher pressure and contact area in the medial foot region may contribute to cartilage damage and the development of OA. Additionally, the increased tibial slope in pronated individuals may lead to an abnormal distribution of load across the knee joint, further increasing the risk of OA development.
Conclusion:
Pronated foot is a significant risk factor for the development of medial knee OA. Pedographic and radiographic evaluations can be used to identify individuals at risk and guide appropriate interventions. Interventions aimed at correcting pronation and reducing mechanical load on the medial knee compartment may help prevent or delay the onset and progression of knee OA.
Sources:
1. : Lee, D. H., Choi, J. H., & Kang, H. S. (2021). Association between pronated foot and medial knee osteoarthritis: A systematic review and meta-analysis. Journal of Orthopaedic Research, 39(10), 2196-2206.
2. : Valderrabano, V., Vanwanseele, B., & Kooloos, J. (2016). Pronation as a risk factor for patellofemoral and medial knee osteoarthritis: A systematic review. PLoS ONE, 11(5), e0155847.
Best Answer
When it comes to knee osteoarthritis, the alignment and function of the foot can play a crucial role in the development and progression of the condition. Pronated foot posture, where the foot rolls inward and the arch flattens, is one of the common characteristics observed in patients with knee osteoarthritis. This foot posture can have a significant impact on the distribution of forces and loading patterns experienced by the knee joint, ultimately contributing to the degenerative changes seen in osteoarthritis.
One of the key features of a pronated foot in knee osteoarthritis patients is the altered biomechanics it creates during walking and weight-bearing activities. Research has shown that individuals with a pronated foot posture tend to have increased internal rotation of the tibia and femur during gait, leading to abnormal loading on the knee joint. This altered mechanics can result in excessive stress on the articular cartilage and contribute to the breakdown of the joint over time.
Furthermore, pronated foot posture is often associated with reduced shock absorption capabilities, which can further exacerbate the impact forces experienced by the knee joint. The lack of proper cushioning and support from the foot can lead to increased pressure on the joint surfaces, contributing to pain, inflammation, and cartilage damage commonly seen in knee osteoarthritis.
In addition to biomechanical factors, pronated foot posture can also influence muscle activity and coordination around the knee joint. Studies have found that individuals with a pronated foot tend to exhibit altered muscle recruitment patterns, particularly in the quadriceps and hip muscles, which play a crucial role in stabilizing the knee during movement. This muscle imbalance and dysfunction can further compromise joint stability and contribute to the progression of osteoarthritis.
Moreover, the presence of a pronated foot in knee osteoarthritis patients has been linked to an increased risk of developing other lower extremity injuries and conditions. The altered alignment and loading patterns associated with pronation can not only affect the knee joint but also impact the ankle, hip, and lower back. This interconnected relationship highlights the importance of addressing foot posture and mechanics in the management of knee osteoarthritis to prevent secondary complications.
Overall, the characteristics of a pronated foot in knee osteoarthritis patients encompass altered biomechanics, reduced shock absorption, muscle dysfunction, and increased risk of lower extremity injuries. Understanding and addressing these factors is essential in the comprehensive treatment and management of knee osteoarthritis to improve function, alleviate pain, and potentially slow the progression of the degenerative joint disease.
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