Dynamic foot function changes following total knee replacement surgery.
BACKGROUND
Individuals with knee osteoarthritis (OA) have flatter/more pronated feet than those without OA, but it is unclear whether altered foot posture and function are a cause or consequence of knee OA. The purpose of this study was to examine whether changes in foot posture and function occur after realignment of the knee following total knee replacement (TKR).


METHODS
Nineteen patients with predominantly medial compartment knee OA were tested prior to and 12 months after TKR. The Foot Posture Index (FPI) and Arch Index (AI) were measured as well as motion of the tibia, rearfoot and forefoot using a 3D motion analysis system incorporating a multisegment foot model.


RESULTS
There were no significant changes in FPI or AI following TKR, however gait analysis revealed significant increases in tibial external rotation (-18.7 ± 7.0° vs -22.5 ± 8.7°, p=0.002), tibial transverse plane range of motion (-9.1 ± 4.6° vs -11.4 ± 6.1°, p=0.0028) and rearfoot range of motion in the frontal plane (8.6 ± 2.6° vs 10.4 ± 2.7°, p=0.002), and a decrease in rearfoot transverse plane range of motion (8.7 ± 5.3° vs 5.9 ± 4.1°, p=0.038) following the procedure.


CONCLUSIONS
TKR produces no change in static foot posture, but results in significant changes in rearfoot kinematics during gait. These findings suggest that rearfoot motion compensates for changes in the alignment of the knee, highlighting the ability of the foot to accommodate for proximal skeletal malalignment.
Institute of Sport, Exercise and Active Living, Victoria University, Melbourne VIC 8001, Australia. Pazit.Levinger@vu.edu.au
Pazit
P
Levinger
Hylton B
HB
Menz
Adam D
AD
Morrow
John R
JR
Bartlett
Julian A
JA
Feller
Mohammad R
MR
Fotoohabadi
Neil R
NR
Bergman
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology