Association of bilateral flat feet with knee pain and disability in patients with knee osteoarthritis: A cross-sectional study
Association of bilateral flat feet with knee pain and disability in patients with knee osteoarthritis: A cross-sectional study
复制标题
DOI：
10.1002/jor.23565
复制
发表时间：
2017-11-01
影响因子：
2.8
通讯作者：
Matsuda, Shuichi
中科院分区：
文献类型：
--
作者：
Iijima, Hirotaka;Ohi, Hiroshi;Matsuda, Shuichi
这项横断面研究探讨了膝关节骨关节炎（OA）患者扁平足与膝关节疼痛、残疾和体能的关系。骨科诊所参与者（n=95;年龄61-91岁; 68.4%女性）内侧间室Kelling-Lawrence（K/L）1级，接受扁平足舟骨高度和足长评价。使用日本膝关节骨关节炎测量、10米步行、定时起身和五次重复椅子站立试验评估膝关节疼痛强度、残疾和身体表现。在95例入组患者中，24例（25.3%）有双侧扁平足，膝关节疼痛显著高于无扁平足的患者（11.3 +/- 8.23分vs. 6.58 +/- 6.37分; p=0.043）。有序逻辑回归分析显示，与无扁平足相比，双侧扁平足与膝关节疼痛增加显著相关（比例比值比：5.48，95%置信区间：1.96，15.3; p=0.001），调整了年龄，性别，体重指数和胫股关节K/L等级，这在扁平足定义的各种不同截止值之间是一致的。有和没有双侧扁平足的患者的身体表现相似。单侧扁平足的存在与任何结局指标均无显著相关性。这些发现表明，双侧而非单侧扁平足与更严重的膝关节疼痛相关。一项前瞻性研究调查了双侧扁平足姿势与膝关节疼痛以及残疾之间的因果关系，这对于验证足部姿势改变的潜在不良影响尤其重要。(c)2017骨科研究学会。出版社：Wiley Periodicals，Inc. J Orthop Res 35：2490-2498，2017.
This cross-sectional study examined the relationship of flat feet with knee pain, disability, and physical performance in patients with knee osteoarthritis (OA). Orthopedic clinic participants (n=95; age 61-91 years; 68.4% women) with Kellgren-Lawrence (K/L) grade 1 in the medial compartment underwent evaluation of navicular height and foot length for flat feet. Knee pain intensity, disability, and physical performance were evaluated using the Japanese Knee Osteoarthritis Measure, 10-m walk, timed up and go, and five-repetition chair stand tests. Of the 95 enrolled patients, 24 (25.3%) had bilateral flat feet, and significantly higher knee pain compared to patients with no flat feet (11.3 +/- 8.23 points vs. 6.58 +/- 6.37 points; p=0.043). A ordinal logistic regression analysis showed that bilateral flat feet were significantly associated with increased knee pain (proportional odds ratio: 5.48, 95% confidence interval: 1.96, 15.3; p=0.001) compared with no flat feet, adjusted for age, sex, body mass index, and tibiofemoral joint K/L grade, which is consistent across various different cutoffs of the definition of flat feet. Physical performance was similar between patients with and without bilateral flat feet. The presence of unilateral flat feet was not significantly associated with any outcome measures. These findings indicate that bilateral, but not unilateral, flat feet are associated with worse knee pain. A prospective study investigating a causal relationship between bilateral flat feet posture and knee pain as well as disability would be of particular interest to verify the potential adverse effect of altered foot posture. (c) 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2490-2498, 2017.