Patil Vishal, Shah Meet, Krishnani Karishma, Jhala Neeha
Department of Orthopaedics, Dr. D. Y. Patil Medical College Hospital and Research Institute, Pimpri-Chinchwad, Maharashtra, India.
Department of Radiodiagnosis, Dr. D. Y. Patil Medical College Hospital and Research Institute, Pimpri-Chinchwad, Maharashtra, India.
J Orthop Case Rep. 2024 Oct;14(10):275-281. doi: 10.13107/jocr.2024.v14.i10.4888.
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.
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.
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).
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.
扁平足，通常被称为平足，其特征是足内侧纵弓降低，导致下肢生物力学改变以及潜在的疼痛和损伤。这种情况会影响下肢的力学对线和动态功能，可能促使膝关节骨关节炎（OA）的发生和发展。本研究旨在调查扁平足与膝关节内侧间室OA之间的关联及其对膝关节功能评分的影响。
这项横断面研究纳入了165名年龄在20至72岁之间的患者。纳入标准为单侧或双侧扁平足患者，排除标准为其他足部疾病、膝关节或踝关节手术史、类风湿关节炎以及肢体长度差异。临床评估包括膝关节压痛、使用足弓指数测量足弓以及对梅里角和胫股（TF）角进行影像学评估。采用膝关节损伤和骨关节炎结局评分（KOOS）来评估膝关节功能。
研究人群的平均年龄为43.98±13.17岁。梅里角范围为5至19°（平均9.46），足弓指数范围为0.220至0.520（平均0.33）。TF角范围为1.7至7.5°（平均4.98）。KOOS评分从10至100不等（平均62.40）。扁平足更严重（梅里角和足弓指数更高）的患者KOOS评分显著更低，表明膝关节功能更差且疼痛更严重。足弓指数、梅里角与KOOS评分之间的相关性具有统计学意义（P = 0.001）。
本研究表明扁平足严重程度与膝关节OA之间存在密切关联。梅里角和足弓指数增加与膝关节功能恶化及疼痛增加相关，这通过KOOS评分得以衡量。这些发现凸显了在内侧间室OA患者中评估足部姿势的重要性，并表明早期干预和矫形治疗可能有助于减轻扁平足患者膝关节OA的进展和严重程度。
