1
|
Albee ME. Take a load off: skeletal implications of sedentism in the feet of modern body donors. Evol Med Public Health 2023; 11:485-501. [PMID: 38162252 PMCID: PMC10756057 DOI: 10.1093/emph/eoad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/13/2023] [Indexed: 01/03/2024] Open
Abstract
Background and Objectives Modern biocultural environments continue to place selective pressures on our skeletons. In the past century, a major cultural pressure has been the rise in sedentism. However, studies considering the effects of sedentism on the foot have largely considered pathological changes to the gross foot without particular regard for the pedal skeleton. To address this gap in the literature, temporal trends in the development of osteoarthritis and entheseal changes on the tarsals and metatarsals were analyzed in the context of biodemographic data for recent modern humans. Methodology The sample utilized for this project is comprised of 71 individuals from the William M. Bass Donated Skeletal Collection, with birth years ranging from 1909 to 1993. Temporal trends in osteoarthritis and entheseal changes were determined via ANCOVA, using year of birth as the explanatory variable and biodemographic variables (age, sex, stature, body mass index and tibial robusticity) as covariates. Results Results indicate that entheseal changes and osteoarthritis have decreased over time, and these trends are statistically significant. Temporal trends in pedal entheseal changes and osteoarthritis vary by sex. Conclusions and Implications The increase in sedentary behavior over time has usually been framed as a net negative for human health and well-being. However, considered in isolation, the decrease in entheseal changes and osteoarthritis presented here might be considered a positive development as they suggest overall less stress on the modern human foot. This study also has the potential to inform the health sciences and general public about biocultural contributors to modern foot health.
Collapse
Affiliation(s)
- Malorie E Albee
- Department of Sociology and Anthropology, Northern Michigan University, Marquette, MI, USA
| |
Collapse
|
2
|
Gates LS, Cherry L, Grønne DT, Roos EM, Skou ST. The prevalence of foot pain and association with baseline characteristics in people participating in education and supervised exercise for knee or hip osteoarthritis: a cross-sectional study of 26,003 participants from the GLA:D® registry. J Foot Ankle Res 2023; 16:83. [PMID: 37993923 PMCID: PMC10666392 DOI: 10.1186/s13047-023-00673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/15/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) affecting the knee or hip is highly prevalent in the general population and has associated high disease burden. Early identification of modifiable risk factors that prevent, limit, or resolve disease symptoms is critical. Foot pain may represent a potentially modifiable factor however little is known about the prevalence of foot pain in people with knee or hip OA nor whether foot pain is associated with clinical characteristics. The main aim of this study was therefore to determine the prevalence of foot pain in people with knee or hip OA attending an education and supervised exercise-based intervention in Denmark (GLA:D®) and determine if baseline demographic or clinical characteristics are associated with foot pain. METHODS Analysis was conducted on baseline data of 26,003 people with symptomatic knee or hip OA completing a pain mannequin as part of the Good Life with osteoArthritis in Denmark (GLA:D®) primary care programme. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the strength of association between baseline clinical characteristics (including pain severity in worst knee/hip joint, number of painful knee/hip joints, pain medication use and physical activity level) and the presence of baseline foot pain. RESULTS Twelve percent of participants (n = 3,049) reported foot pain. In those people with index knee OA (n = 19,391), knee pain severity (OR 1.01 CI 1.00, 1.01), number of painful knee/hip joints (OR 1.67 CI 1.58, 1.79), and use of pain medication (OR 1.23 CI 1.12, 1.36) were statistically associated with foot pain. Excluding use of pain medication, similar associations were seen in those with index hip OA. CONCLUSION Twelve percent of people with knee or hip OA participating in GLA:D® had foot pain. Those with worse knee/hip pain, and greater number of painful joints were more likely to report foot pain. This study is the first to demonstrate a significant relationship between clinical characteristics and foot pain in people with knee or hip OA participating in education and supervised exercise. Future investigation should consider the role that foot pain may play on knee and hip related outcomes following therapeutic intervention.
Collapse
Affiliation(s)
- Lucy S Gates
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Lindsey Cherry
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK.
- Solent NHS Trust, Southampton, UK.
| | - Dorte T Grønne
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark
| |
Collapse
|
3
|
Perry TA, Segal NA, Bowen C, Gates L, Arden N, Nevitt MC. Foot and ankle pain and risk of incident knee osteoarthritis and knee pain: Data from the Multicentre Osteoarthritis Study. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 3:100210. [PMID: 34977597 PMCID: PMC8683744 DOI: 10.1016/j.ocarto.2021.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To examine whether foot and/or ankle pain increases the risk of knee OA. Design We utilised longitudinal data from the Multicentre Osteoarthritis Study (MOST); a community-based cohort of risk factors for knee OA. Participants without frequent knee pain (clinic visit only) and radiographic knee OA (RKOA) at baseline and, with no evidence of inflammatory musculoskeletal disease and a history of knee-related surgery were followed for up to 84-months for incident outcomes; i) RKOA (Kellgren-Lawrence (KL) ≥2), ii) symptomatic RKOA (RKOA and frequent pain in the same knee) and iii) frequent knee pain only. At baseline, ankle and foot symptoms were assessed, with knee radiographs and symptoms also assessed at 30, 60 and 84-months. Our exposures included baseline ankle, foot, and ankle and foot pain (participant-level). Associations between foot and/or ankle pain and incident outcomes were assessed using multiple logistic regression, with adjustment for participant characteristics and ankle/foot pain. Results No statistically significant associations were observed between ankle, foot and, ankle and foot pain and incident RKOA, respectively. Ankle pain with (2.30, 95% CI 1.13 to 4.66) and without foot pain (OR: 2.53, 95% CI 1.34 to 4.80) were associated with increased odds of incident symptomatic RKOA and frequent knee pain. No statistically significant associations were observed between foot pain and these outcomes. Conclusions Ankle pain should be a focus point, more so than foot pain, in the management of knee OA. Future studies should include additional ankle joint-specific symptom questions to better elucidate the knee OA biomechanical pathway.
Collapse
Affiliation(s)
- Thomas A. Perry
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, United Kingdom
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Corresponding author. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, United Kingdom.
| | - Neil A. Segal
- University of Kansas Medical Centre, Kansas City, KS, USA
- The University of Iowa, Iowa City, USA
| | - Catherine Bowen
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Southampton, Southampton, United Kingdom
| | - Lucy Gates
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Southampton, Southampton, United Kingdom
| | - Nigel Arden
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, United Kingdom
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, San Francisco, CA 94158, USA
| |
Collapse
|
4
|
Tse CTF, Ryan MB, Dien J, Scott A, Hunt MA. An exploration of changes in plantar pressure distributions during walking with standalone and supported lateral wedge insole designs. J Foot Ankle Res 2021; 14:55. [PMID: 34615545 PMCID: PMC8493692 DOI: 10.1186/s13047-021-00493-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration. Methods In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot were divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. Results Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. Conclusions Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00493-5.
Collapse
Affiliation(s)
- Calvin T F Tse
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada.,Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.,Kintec Footlabs Inc, Surrey, BC, Canada
| | - Michael B Ryan
- Kintec Footlabs Inc, Surrey, BC, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Jason Dien
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada
| | - Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Michael A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada. .,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
5
|
Tu L, Zheng S, Cicuttini F, Jin X, Han W, Zhu Z, Antony B, Winzenberg T, Jones G, Gu J, Wluka AE, Ding C. Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2021; 73:781-787. [PMID: 32623812 DOI: 10.1002/acr.24371] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA). METHODS A post hoc study was conducted from a randomized, double-blind, placebo-controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25-hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D3 or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1-9 and 11) being documented as on "most/every day(s)" in the last month. A repeated-measures, mixed-effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders. RESULTS A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (-0.03 versus 1.30; P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (-0.09 versus 2.19; P = 0.001). CONCLUSION Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.
Collapse
Affiliation(s)
- Liudan Tu
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, and University of Tasmania, Hobart, Tasmania, Australia
| | - Shuang Zheng
- University of Tasmania, Hobart, Tasmania, Australia
| | | | - Xingzhong Jin
- University of Tasmania, Hobart, Tasmania, and the University of Sydney, New South Wales, Australia
| | - Weiyu Han
- University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaohua Zhu
- University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Benny Antony
- University of Tasmania, Hobart, Tasmania, Australia
| | | | - Graeme Jones
- University of Tasmania, Hobart, Tasmania, Australia
| | - Jieruo Gu
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | - Changhai Ding
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, University of Tasmania, Hobart, Tasmania, Australia, Monash University, Melbourne, Victoria, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
6
|
Kunugiza Y, Tomita T, Hirao M, Hamada M, Hosono N. Amelioration in Ankle Pain and Improvement in Function After Total Knee Arthroplasty for Ipsilateral Knee and Ankle Osteoarthritis: A Report of Two Cases. Arthroplast Today 2020; 6:925-930. [PMID: 33225035 PMCID: PMC7666310 DOI: 10.1016/j.artd.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 11/19/2022] Open
Abstract
We report 2 cases of ipsilateral ankle and knee osteoarthritis (OA), with the chief complaint being chronic ankle and knee pain. In the first patient, the ankle pain was more severe than the knee pain, whereas the second patient had more severe pain in the knee than in the ankle. In both cases, varus malalignment of the knee and varus tilt of the ankle joint were detected on standing radiographs. The severity of OA was found to be grade 4 in the knee, according to the Kellgren–Lawrence grading system, and stage IIIa in the ankle, according to the modified Takakura ankle OA classification system. Navigation-assisted total knee arthroplasty was performed in both cases, leading to a decreased degree of varus malalignment in the knee and ankle, as well as a significantly improved patient-based outcome in both joints. Correction of malalignment of the ankle by total knee arthroplasty relieved the severe pain and restored optimal function in the ankle without surgical intervention.
Collapse
Affiliation(s)
- Yasuo Kunugiza
- Department of Orthopedics, JCHO Hoshigaoka Medical Center, Osaka, Japan
| | - Tetsuya Tomita
- Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makoto Hirao
- Department of Orthopedics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masayuki Hamada
- Department of Orthopedics, JCHO Hoshigaoka Medical Center, Osaka, Japan
| | - Noboru Hosono
- Department of Orthopedics, JCHO Hoshigaoka Medical Center, Osaka, Japan
| |
Collapse
|
7
|
Canetti EFD, Schram B, Orr RM, Knapik J, Pope R. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A systematic review and meta-analysis. APPLIED ERGONOMICS 2020; 86:103097. [PMID: 32342888 DOI: 10.1016/j.apergo.2020.103097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
This systematic review and meta-analysis identified and critically reviewed the findings of recent studies (last 15 years) examining relationships between specific physically demanding occupations or occupational tasks and development of lower limb osteoarthritis (OA). Twenty-eight studies with 266,227 cases of lower limb OA were included. Occupational tasks contributing to OA included farming, floor laying, and brick laying. Activities significantly contributing to the risk of knee OA were lifting heavy loads (>10 kg/week) (odds ratio [OR] = 1.52, 95% confidence interval [95%CI] 1.29-1.79), squatting/kneeling (OR = 1.69, 95%CI 1.15-2.49), standing (>2 h/daily) (OR = 1.22 95%CI 1.02-1.46) and walking (OR = 1.40 95%CI 1.14-1.73). Lifting contributed significantly to the risk of hip OA (OR = 1.35, 95%CI 1.16-1.57). The effects of occupational exposures appear to be magnified by previous injury and BMI >25 kg/m2. Since specific occupational activities increase OA risk, ergonomist should encourage the use of existing tools, or oversee the design of new tools that may decrease exposure to such activities.
Collapse
Affiliation(s)
- Elisa F D Canetti
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Robin M Orr
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Joseph Knapik
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Rodney Pope
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia; School of Community Health, Charles Sturt University, Elizabeth Mitchell Dr, Thurgoona, NSW, 2640, Australia.
| |
Collapse
|
8
|
Wang J, Lv HZ, Chen W, Fan MK, Li M, Zhang YZ. Anatomical Adaptation of Fibula and its Mechanism of Proximal Partial Fibulectomy Associated with Medial Compartment Knee Osteoarthritis. Orthop Surg 2019; 11:204-211. [PMID: 30955245 PMCID: PMC6594497 DOI: 10.1111/os.12437] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives To reveal the anatomical adaptation of the fibula and its relations to age and settlement of the medial tibial plateau, and to explore the mechanism of proximal partial fibulectomy in treating medial compartment knee osteoarthritis (OA). Methods A retrospective study was performed in the Third Hospital of Hebei Medical University. Weight‐bearing full‐leg anteroposterior (AP) radiographs of 280 adults (560 knees) obtained from 1 January 2018 to 31 October 2018 were enrolled according to our inclusion and exclusion criteria, including 157 men and 123 women, with an average age of 50.3 ± 14.8 years (range, 19–80 years). Radiographic severity of knee OA was assessed using Kellgren and Lawrence (K–L) grading. The settlement of the medial tibial plateau was evaluated using the medial proximal tibial angle (MPTA). Curvatures of the tibia and the fibula were measured as proximal tibial curvature (PTC), distal tibial curvature (DTC), proximal fibular curvature (PFC), and distal fibular curvature (DFC). Two orthopaedic surgeons performed all the radiological measurements for 30 randomly selected patients, and repeated the measurements 1 week later. Based on the satisfactory intra‐observer and inter‐observer reliabilities (ICC > 0.9), each parameter was analyzed in this study. Multivariable linear regression models were used to examine relations between radiological measurements and age. Results The mean MPTA, PTC, DTC, PFC, and DFC were 85.4° ± 2.8°, 176.2° ± 1.9°, 176.8° ± 1.8°, 176.8° ± 1.9°, and 177.0° ± 2.0°, respectively. Ninety‐three knees of K–L grade I were categorized as non‐knee OA, and 467 knees of K–L grades II–IV were categorized as knee OA. The MPTA, PTC, and PFC of the knee OA group were significantly smaller than those of non‐knee OA group (P < 0.05). The K–L grade of knee OA significantly increased with age (χ2 = 182.169, P < 0.01). The multivariate linear regression analysis indicated that the MPTA and fibular curvatures were negatively correlated with age (the regression equation is age = 561.165–0.945 MPTA‐0.937 PFC‐0.959 DFC, P < 0.05), and the MPTA was negatively correlated with PFC (the regression equation is MPTA = 7.827 + 0.099 DFC, P < 0.05). Conclusions The proximal curve of the fibula increased in patients with medial compartment knee OA, and this change was positively correlated with age and settlement of the medial tibial plateau. This anatomical adaptation of the fibula was associated with greater fibular axial load and the pulling from the peroneus longus. The proximal partial fibulectomy procedure effected a receptive foot pronation to reduce KAM and rebalance the biceps‐proximal fibula–peroneus longus complex, consequently achieving medial compartment unloading.
Collapse
Affiliation(s)
- Juan Wang
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hong-Zhi Lv
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Chen
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng-Ke Fan
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ming Li
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying-Ze Zhang
- Editorial Department, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
9
|
Clinical Assessment and Management of Foot and Ankle Osteoarthritis: A Review of Current Evidence and Focus on Pharmacological Treatment. Drugs Aging 2019; 36:203-211. [DOI: 10.1007/s40266-019-00639-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|