Early diagnosis of coxarthrosis (in-shoe plantar pressure measurements)

Proximal femoral nail shows better concordance of gait analysis between operated and uninjured limbs compared to hemiarthroplasty in intertrochanteric femoral fractures

PURPOSE

The purpose of this study was to compare the results of pedobarographic gait analysis between the patients treated by proximal femoral nail or bipolar partial hemiarthroplasty due to intertrochanteric fractures.

METHODS

Thirty-seven patients with a minimum 1-year follow-up who had been operated for intertrochanteric fractures were evaluated clinically, radiologically and with pedobarographic gait analysis. Proximal femoral nail had been performed to 21 patients (group A), whilst 16 patients had been operated by partial bipolar hemiarthroplasty (group B). Pedobarographic analysis was performed by measuring plantar pressure, force and contact area values in both static and dynamic manner. Pedobarographic results of operated limb were compared among groups. Same data's also were compared between operated and uninjured limbs in each group to determine any asymmetry on weight-bearing.

RESULTS

Average follow-up period in group A and group B was 36 (12-56) and 30 (12-48) months, respectively. There were no statistically significant differences among groups in terms of age, gender, body mass index, type and side of fracture, follow-up period, leg length discrepancy and postoperative hip scores. When the pedobarographic results of operated limb were compared, group B showed much more plantar force and pressure values than group A, on both static and dynamic evaluations. If the evaluation was taken into consideration to comparison of pedobarographic results between operated and uninjured limbs in each group, we found asymmetry in static load bearing, caused by higher load on uninjured limb in both groups. However, there was no statistically significant asymmetry between operated and uninjured limbs in respect to dynamic pedobarographic parameters for patients in group A. On the contrary, operated limbs in group B exposed much more plantar force and pressure values than uninjured limbs, which indicated asymmetric weight-bearing on dynamic evaluation.

CONCLUSIONS

Assessment of pedobarographic parameters can be another way of measuring the results of treatment in intertrochanteric fractures. Uninjured limbs of patients expose much more loading than operated limbs in postoperative static evaluation for both treatment options. However in dynamic evaluation, there is a better concordance of gait analysis between both limbs in patients operated by proximal femoral nail.

Pedobarographic findings in patients with knee osteoarthritis

OBJECTIVE

The aim of this study was to evaluate pedobarographic findings and balance in knee osteoarthritis.

DESIGN

A total of 48 patients with knee osteoarthritis and 30 controls were included in this study. Pedobarographic measures were obtained from all patients and controls. Pain intensity of patients was measured using the Visual Analog Scale. The percentage of pressure on forefoot and hindfoot was measured using static pedobarography, and the peak pressures at forefoot, midfoot, and hindfoot were measured using dynamic pedobarography. The center-of-pressure sway length and width were measured for evaluation of balance.

RESULTS

The percentage of right hindfoot pressure (P < 0.05) and peak pressure of the right forefoot during walking were lower in the osteoarthritic group than in the controls (P < 0.05). The sway width in the patient group was higher than in the control group (P < 0.05). The Visual Analog Scale score at rest was negatively correlated with peak pressures of both right and left hindfeet in the osteoarthritic group (P < 0.05). The grade of osteoarthritis was positively correlated with sway length and sway width (P < 0.05).

CONCLUSION

Pedobarography may become a useful technique to determine foot pressures that change because of disturbed weightbearing and balance problems in knee osteoarthritis.