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Dynamic foot function changes following total knee replacement surgery.

Abstract

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).
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.
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° vs -22.5 ± 8.7°, p=0.002), tibial transverse plane range of motion (-9.1 ± 4.6° vs -11.4 ± 6.1°, p=0.0028) and rearfoot range of motion in the frontal plane (8.6 ± 2.6° vs 10.4 ± 2.7°, p=0.002), and a decrease in rearfoot transverse plane range of motion (8.7 ± 5.3° vs 5.9 ± 4.1°, p=0.038) following the procedure.
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.

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  • Publisher Full Text
  • Authors

    Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Fotoohabadi MR, Bergman NR

    Institution

    Institute of Sport, Exercise and Active Living, Victoria University, Melbourne VIC 8001, Australia. Pazit.Levinger@vu.edu.au

    Source

    The Knee 19:6 2012 Dec pg 880-5

    MeSH

    Aged
    Arthroplasty, Replacement, Knee
    Cohort Studies
    Female
    Foot
    Humans
    Male
    Middle Aged
    Osteoarthritis, Knee
    Range of Motion, Articular
    Treatment Outcome
    Walking
    Weight-Bearing

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22672961