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晚期内侧膝关节骨关节炎患者的足部压力模式、后足畸形及其与足部疼痛的关联。

Foot pressure pattern, hindfoot deformities, and their associations with foot pain in individuals with advanced medial knee osteoarthritis.

作者信息

Saito Isao, Okada Kyoji, Wakasa Masahiko, Abe Hidekazu, Saito Akira

机构信息

Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan; Division of Rehabilitation, Ugo Municipal Hospital, Ugo, Japan.

Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan.

出版信息

Gait Posture. 2018 Jan;59:83-88. doi: 10.1016/j.gaitpost.2017.09.041. Epub 2017 Oct 6.

Abstract

This survey clarified foot pressure patterns and hindfoot deformities in individuals with advanced knee osteoarthritis (OA) and analyzed their associations with foot pain. Sixty-four individuals with unilateral knee OA who underwent total knee arthroplasty (TKA) were divided into the following groups: no foot pain (n=26; men:women, 4:22; mean age, 73.7 years), foot pain resolved after TKA (12; 2:10; 75.8), and foot pain remaining after TKA (26; 4:22; 74.7). Elderly individuals without pain or deformity in either knee (54; 10:44; 74.3) were controls. Navicular height ratio of the medial longitudinal arch, leg-heel angle, and partial foot pressure as the percentage of body weight (%PFP) were calculated.%PFPs of the medial and lateral heel regions before TKA were significantly lower for the no foot pain group than for controls. One year after TKA, %PFP improved significantly. In the foot pain resolved group, before TKA, the leg-heel angle was significantly higher, and%PFPs of the medial and lateral heel regions and navicular height ratio before TKA were significantly lower than those of controls. One year after TKA, all parameters improved significantly. In the foot pain remaining group, similar abnormalities were observed before TKA; however, significant improvement was only observed for%PFP of the medial heel region 1year after TKA. More than half of the patients with advanced knee OA had foot pain. This improved in approximately one-third, 1year after TKA. Hindfoot deformities are probably associated with foot pain in individuals with advanced knee OA.

摘要

本调查明确了晚期膝骨关节炎(OA)患者的足部压力模式和后足畸形情况,并分析了它们与足部疼痛的关联。64名单侧膝OA且接受全膝关节置换术(TKA)的患者被分为以下几组:无足部疼痛组(n = 26;男∶女为4∶22;平均年龄73.7岁)、TKA后足部疼痛缓解组(12例;2∶10;75.8岁)和TKA后仍有足部疼痛组(26例;4∶22;74.7岁)。双侧膝关节均无疼痛或畸形的老年人(54例;10∶44;74.3岁)作为对照组。计算内侧纵弓的舟骨高度比、腿-跟角以及部分足部压力占体重的百分比(%PFP)。无足部疼痛组TKA前内侧和外侧足跟区域的%PFP显著低于对照组。TKA后1年,%PFP显著改善。在足部疼痛缓解组,TKA前腿-跟角显著更高,TKA前内侧和外侧足跟区域的%PFP以及舟骨高度比显著低于对照组。TKA后1年,所有参数均显著改善。在足部疼痛仍存组,TKA前观察到类似异常;然而,TKA后1年仅内侧足跟区域的%PFP有显著改善。超过一半的晚期膝OA患者有足部疼痛。TKA后1年,约三分之一的患者疼痛得到改善。后足畸形可能与晚期膝OA患者的足部疼痛相关。

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