Association between foot posture and tibiofemoral contact forces during barefoot walking in patients with knee osteoarthritis

Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights

The increased incidence of osteoarthritis (OA), particularly knee and hip OA, and osteoporosis (OP), owing to population aging, have escalated the medical expense burden. Osteoarthritis is more prevalent in older women, and the involvement of subchondral bone fragility spotlights its association with OP. Notably, subchondral insufficiency fracture (SIF) may represent a more pronounced condition of OA pathophysiology. This review summarizes the relationship between OA and OP, incorporating recent insights into SIF. Progressive SIF leads to joint collapse and secondary OA and is associated with OP. Furthermore, the thinning and fragility of subchondral bone in early-stage OA suggest that SIF may be a subtype of OA (osteoporosis-related OA, OPOA) characterized by significant subchondral bone damage. The high bone mineral density observed in OA may be overestimated due to osteophytes and sclerosis and can potentially contribute to OPOA. The incidence of OPOA is expected to increase along with population aging. Therefore, prioritizing OP screening, early interventions for patients with early-stage OA, and fracture prevention measures such as rehabilitation, fracture liaison services, nutritional management, and medication guidance are essential.

Translation, Cross-Cultural Adaptation, and Validation of the Foot Posture Index (FPI-6)-Italian Version

Since foot posture is one of the main predictors of lower limb musculoskeletal injuries, it is crucial to use appropriate tools to define the foot's posture. The Foot Posture Index is, therefore, a reliable method to measure foot posture and is widely known and used in clinics and research. This study aimed to translate the Foot Posture Index 6 (FPI6) into Italian and to assess its psychometric properties. Translation and cross-cultural adaptation were obtained using a popular guideline. Two examinators assessed 68 subjects, and data were collected to test intra/inter-rater reliability, internal consistency and cross-cultural validity. The Italian version of FPI6 showed excellent inter- and intra-rater reliability (ICC 0.96 and 0.97), and Cronbach's alpha coefficient was 0.9, thus showing excellent internal consistency. The FPI-6 version has proved to be reliable in terms of inter- and intra-rater reliability and can, therefore, be used in clinical practice and scientific research.

Relationship between fall history and toe grip strength in older adults with knee osteoarthritis in Japan: A cross-sectional study

BACKGROUND

Knee osteoarthritis (KOA), one of the most common musculoskeletal diseases in older adults, is associated with a high incidence of falls. Similarly, toe grip strength (TGS) is associated with a history of falls in older adults; however, the relationship between TGS and falls in older adults with KOA who are at risk of falling is not known. Therefore, this study aimed to determine if TGS is associated with a history of falls in older adults with KOA.

METHODS

The study participants, older adults with KOA scheduled to undergo unilateral total knee arthroplasty (TKA), were divided into two groups: non-fall (n = 256) and fall groups (n = 74). Descriptive data, fall-related assessments, modified Fall Efficacy Scale (mFES), radiographic data, pain, and physical function including TGS were evaluated. The assessment was conducted on the day before performing TKA. Mann-Whitney and chi-squared tests were performed to compare the two groups. Multiple logistic regression analysis was performed to determine the association of each outcome with the presence or absence of falls.

RESULTS

Mann-Whitney U test revealed that the fall group had statistically significantly lower height, TGS on the affected and unaffected sides, and mFES. Multiple logistic regression analysis revealed that the incidence of fall history is associated with TGS on the affected side; the weaker the affected TGS of the KOA, the more likely the individual is to fall.

CONCLUSIONS

Our results indicate that TGS on the affected side is related to a history of falls in older adults with KOA. The significance of evaluating TGS among patients with KOA in routine clinical practice was demonstrated.