Abstract
BackgroundWhile abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined. This study aimed to examine whether rearfoot posture is associated with a higher prevalence of radiographic PFOA in a compartment-specific manner in patients with medial tibiofemoral osteoarthritis (TFOA).MethodsParticipants from orthopedic clinics (n = 68, age 56–90 years, 75.0% female), diagnosed with radiographic medial TFOA (Kellgren/Lawrence [K/L] grade ≥ 2) were included in this study. The presence of PFOA and static rearfoot posture were evaluated using a radiographic skyline view and a footprint automatic measurement apparatus, respectively. The relationship between rearfoot posture and PFOA was examined using analysis of covariance and propensity score-adjusted logistic regression analysis.ResultsOn average, patients with coexisting PFOA and medial TFOA (n = 39) had an inverted calcaneus 3.1° greater than those with isolated medial TFOA (n = 29). Increased calcaneus inverted angle was significantly associated with a higher probability of the presence of medial PFOA (odds ratio: 1.180, 95% confidence interval: [1.005, 1.439]; p = 0.043). Calcaneus inverted angle was not associated with higher odds of lateral PFOA presence based on the adjusted values.ConclusionsThe presence of an inverted rearfoot was associated with PFOA. Although these findings do not clearly indicate a biomechanical link between rearfoot posture and PFOA, this study shed light on the potential relationship between altered rearfoot posture and PFOA, as can be seen between rearfoot abnormality and PF pain.
Highlights
While abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined
Participants Participants of this exploratory study were recruited from the 12-month follow-up period of a prospective cohort of subjects described in a previous study, which investigated the clinical impact of coexisting PFOA in patients with medial tibiofemoral osteoarthritis (TFOA) [21]
75 were excluded from this study; 41 could not be contacted or declined follow up for non-specific reasons; and 34 were excluded because of missing data on patient’s characteristics, radiography, and rearfoot posture at the 12 months follow up period (January 2015)
Summary
While abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined. This study aimed to examine whether rearfoot posture is associated with a higher prevalence of radiographic PFOA in a compartment-specific manner in patients with medial tibiofemoral osteoarthritis (TFOA). The relationship between altered foot posture during gait and PF pain was thoroughly discussed in the literature [16] and rearfoot abnormalities may be associated with PF pain [17]. Foot orthoses were effective in improving anterior knee pain in patients with isolated lateral PFOA [19], we are not aware of any studies that investigated the relationship between rearfoot posture and PFOA
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