A Strong Correlation Between the Severity of Flatfoot and Symptoms of Knee Osteoarthritis in 95 Patients

The Impact of Pes Planus on Knee Function and Its Association with Medial Compartment Knee Osteoarthritis

Introduction

Pes planus, commonly known as flat foot, is characterized by the lowering of the medial longitudinal arch of the foot, leading to alterations in lower limb biomechanics and potential pain and injury. This condition can affect the mechanical alignment and dynamic function of the lower limb, potentially contributing to the development and progression of knee osteoarthritis (OA). This study aims to investigate the association between pes planus and medial compartment knee OA as well as its impact on the knee functional score.

Materials and Methods

This cross-sectional study included 165 patients aged 20-72 years. Inclusion criteria were individuals with unilateral or bilateral flat feet, while exclusion criteria were other foot conditions, history of knee or ankle surgeries, rheumatoid arthritis, and limb length discrepancies. Clinical assessments included knee joint tenderness, foot arch measurement using the foot arch index, and radiographic evaluations of Meary's angle and tibiofemoral (TF) angle. The knee injury and osteoarthritis outcome score (KOOS) was used to assess knee function.

Results

The study population had a mean age of 43.98 ± 13.17 years. Meary's angle ranged from 5 to 19° (mean 9.46), and the foot arch index ranged from 0.220 to 0.520 (mean 0.33). The TF angle ranged from 1.7 to 7.5° (mean 4.98). KOOS scores varied from 10 to 100 (mean 62.40). Patients with more severe flat feet (higher Meary's angle and foot arch index) had significantly lower KOOS scores, indicating worse knee function and greater pain. The correlations between foot arch index, Meary's angle, and KOOS scores were statistically significant (P = 0.001).

Conclusion

This study demonstrates a strong association between flat foot severity and knee OA. Increased Meary's angle and foot arch index were correlated with worsened knee function and increased pain, as measured by KOOS scores. These findings highlight the importance of assessing foot posture in patients with medial compartment OA and suggest that early intervention and orthotic management could be beneficial in mitigating the progression and severity of knee OA in patients with pes planus.

Correlation of progressive collapsing foot deformity with varus knee alignment in young adults - A case control study

Background

Majority of patients with Progressive Collapsing Foot Deformity(PCFD) have symptoms pertaining to the knee. Malalignment at the foot will have effects on the alignment of the knee. In this case control study, we compare the alignment of the knees between patients with PCFD and controls.

Materials

Sixty subjects, 30 PCFD and 30 controls, underwent radiographs in which the tibiofemoral angle and radiological parameters of PCFD were assessed. Parameters of PCFD were correlated with the tibiofemoral angle.

Results

Mean tibiofemoral angle was 3.8° among the cases and 4.8° among the controls which was statistically significant(P = 0.001). Varus knee alignment was seen in 41 out of 60 limbs with PCFD which was statistically significant(P < 0.001). The tibiofemoral angle correlated significantly with the Meary angle(P = 0.03) and the talonavicular coverage angle(P = 0.003).

Conclusions

PCFD is associated with varus knee malalignment. This varus deformity early in adulthood may lead to deleterious effects like medial compartment osteoarthritis in later life. Early intervention for such patients may help avoid this knee damage.

Level of evidence

Level 3-prognostic.

Efficacy of Plantar Orthoses in Paediatric Flexible Flatfoot: A Five-Year Systematic Review

Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of conservative and surgical treatments, with foot orthoses (FO) being the first line of treatment due to their lack of contraindications and because the active participation of the child is not required, although the evidence supporting them is weak. It is not clear what the effect of FO is, nor when it is advisable to recommend them. PFF, if left untreated or uncorrected, could eventually cause problems in the foot itself or adjacent structures. It was necessary to update the existing information on the efficacy of FO as a conservative treatment for the reduction in signs and symptoms in patients with PFF, to know the best type of FO and the minimum time of use and to identify the diagnostic techniques most commonly used for PFF and the definition of PFF. A systematic review was carried out in the databases PubMed, EBSCO, Web of Science, Cochrane, SCOPUS and PEDro using the following strategy: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) on child patients with PFF, compared to those treated with FO or not being treated, assessing the improvement of signs and symptoms of PFF. Studies in which subjects had neurological or systemic disease or had undergone surgery were excluded. Two of the authors independently assessed study quality. PRISMA guidelines were followed, and the systematic review was registered in PROSPERO: CRD42021240163. Of the 237 initial studies considered, 7 RCTs and CCTs published between 2017 and 2022 met the inclusion criteria, representing 679 participants with PFF aged 3-14 years. The interventions of the included studies differed in diagnostic criteria, types of FO and duration of treatment, among others. All articles conclude that FO are beneficial, although the results must be taken with caution due to the risk of bias of the included articles. There is evidence for the efficacy of FO as a treatment for PFF signs and symptoms. There is no treatment algorithm. There is no clear definition for PFF. There is no ideal type of FO, although all have in common the incorporation of a large internal longitudinal arch.

Correlation between flat foot and patellar instability in adolescents and analysis of related risk factors

INTRODUCTION

Flatfoot and patellar instability are both developmental limb deformities that occur frequently in adolescents. A high number of patients with both diseases can be seen in clinic, and there are no studies showing a correlation between the two. The goal of this study is to investigate the association between developmental patellar instability and flat feet in adolescents and its associated risk factors.

METHODS

This experiment uses a cross-sectional study to select 74 adolescent patients with flat foot from a randomly selected middle school in this city since December 2021 and obtain relevant data. SPSS26.0 statistical software was used for data analysis. Quantitative data were expressed as mean ± standard deviation, and Pearson correlation coefficient was used for analysis. p < 0.05 indicates a statistically significant difference.

RESULTS

A total of 74 people (40 men and 34 women) were included in this study. The correlation coefficients between Meary angle, Pitch angle, calcaneal valgus angle, CSI, BMI, and Beighton scores and knee joint Q angle are 0.358 (p < 0.01), -0.312 (p < 0.01), 0.403 (p < 0.01), 0.596 (p < 0.01), 0.427 (p < 0.01), and 0.293 (p < 0.05), respectively, indicating that flat foot, overweight, and Beighton scores are all correlated with Q angle. The correlation coefficients between Meary angle, Pitch angle, calcaneal valgus angle, CSI, and BMI were 0.431 (p < 0.01), -0.399 (p < 0.01), 0.319 (p < 0.01), and 0.563 (p < 0.01), respectively, indicating a correlation between flat foot and BMI. The correlation coefficients between Meary's angle, Pitch's angle, calcaneal valgus angle, CSI, and Beighton's score were 0.207 (p > 0.05), -0.240 (p < 0.05), 0.204 (p > 0.05), and 0.413 (p < 0.01), respectively, indicating a correlation between flat foot and Beighton's score.

CONCLUSION

We believe that there is a significant correlation between adolescent flatfoot and patellar instability. Excessive weight and ligamental laxity during adolescent development are among the risk factors for flatfoot and patellar instability.