Martinelli Nicolò, Bergamini Alberto Nicolò, Burssens Arne, Toschi Filippo, Kerkhoffs Gino M M J, Victor Jan, Sansone Valerio
IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.
J Clin Med. 2022 Apr 17;11(8):2245. doi: 10.3390/jcm11082245.
A convincing association between the foot and ankle alignment (FAA) and patellofemoral pain syndrome (PFPS) remains debatable in the literature. Therefore, all studies investigating the role of FAA in patients with PFPS were systematically reviewed.
A systematic literature search was performed on the databases PubMed, Embase, Cochrane Library, and Web of Science. Inclusion criteria were all studies investigating static and/or dynamic FAA factors and PFPS. Studies with less than 20 patients or with patellofemoral osteoarthritis were excluded. The quality assessment was based on Cochrane study criteria, and the maximum score was set at eight.
Of 2246 articles, only 13 case-control studies were eligible. Considering static FAA factors, two studies found an association with rearfoot eversion and one with rearfoot inversion. While examining dynamic FAA characteristics, one study found an association with rearfoot eversion range of motion and three with gait kinematics. No further associations were reported. The quality assessment mean score was 5.5 (SD = 0.97) corresponding to moderate quality.
In contrast to our expectations, a limited number of studies were founded supporting an association between FAA and PFPS. At present, the quality of the literature is still poor and conflicting, thus the need for further studies to determine any association between FAA and PFPS.
足踝对线（FAA）与髌股疼痛综合征（PFPS）之间令人信服的关联在文献中仍存在争议。因此，对所有研究FAA在PFPS患者中作用的研究进行了系统综述。
在PubMed、Embase、Cochrane图书馆和科学网数据库上进行了系统的文献检索。纳入标准为所有研究静态和/或动态FAA因素与PFPS的研究。排除患者少于20例或患有髌股骨关节炎的研究。质量评估基于Cochrane研究标准，最高分为8分。
在2246篇文章中，只有13项病例对照研究符合条件。考虑静态FAA因素，两项研究发现与后足外翻有关，一项与后足内翻有关。在检查动态FAA特征时，一项研究发现与后足外翻运动范围有关，三项与步态运动学有关。未报告其他关联。质量评估平均得分为5.5（标准差=0.97），对应中等质量。
与我们的预期相反，发现支持FAA与PFPS之间存在关联的研究数量有限。目前，文献质量仍然很差且相互矛盾，因此需要进一步研究以确定FAA与PFPS之间的任何关联。
