Abstract
BackgroundFoot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb. This study compared foot posture in people with and without medial compartment knee osteoarthritis (OA) using a range of clinical foot measures. The reliability of the foot measures was also assessed.MethodsThe foot posture of 32 patients with clinically and radiographically-confirmed OA predominantly in the medial compartment of the knee and 28 asymptomatic age-matched healthy controls was investigated using the foot posture index (FPI), vertical navicular height and drop, and the arch index. Independent t tests and effect size (Cohen's d) were used to investigate the differences between the groups in the foot posture measurements.ResultsSignificant differences were found between the control and the knee OA groups in relation to the FPI (1.35 ± 1.43 vs. 2.46 ± 2.18, p = 0.02; d = 0.61, medium effect size), navicular drop (0.02 ± 0.01 vs. 0.03 ± 0.01, p = 0.01; d = 1.02, large effect size) and the arch index (0.22 ± 0.04 vs. 0.26 ± 0.04, p = 0.04; d = 1.02, large effect size). No significant difference was found for vertical navicular height (0.24 ± 0.03 vs. 0.23 ± 0.03, p = 0.54; d = 0.04, negligible effect size).ConclusionPeople with medial compartment knee OA exhibit a more pronated foot type compared to controls. It is therefore recommended that the assessment of patients with knee OA in clinical practice should include simple foot measures, and that the potential influence of foot structure and function on the efficacy of foot orthoses in the management of medial compartment knee OA be further investigated.
Highlights
Foot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb
Low coefficients of variation were found for the foot posture index (FPI), navicular height and arch index (Table 2)
A significant correlation was found between body weight and the arch index (r = 0.44, p < 0.001) with no significant correlation between body weight and FPI (r = 0.22, p = 0.09), navicular height (r = 0.008, p = 0.94) or navicular drop (r = 0.20, p = 0.12)
Summary
Foot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb. The forces transmitted across the knee joint are greater in the medial compartment compared to the lateral compartment [4], and increased medial compartment loading has been observed in patients with knee OA [5,6,7,8]. Foot posture has long been considered to contribute to the development of a range of lower limb musculoskeletal conditions [19,20] as it may alter the mechanical alignment and dynamic function of the lower limb [21]. In order to fully understand the effect of these interventions on the knee and other lower limb joints and to identify patients who are most likely to benefit from them, greater knowledge of foot structure in this population is required
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