• 1.

    Kul-Panza E, Berker N: Pedobarographic findings in patients with knee osteoarthritis. Am J Phys Med Rehabil 85: 228, 2006.

  • 2.

    Duncan R, Peat G, Thomas E, et al: Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be? Ann Rheum Dis 66: 86, 2007.

  • 3.

    McAlindon T, Zhang Y, Hannan M, et al: Are risk factors for patellofemoral and tibiofemoral knee osteoarthritis different? J Rheumatol 23: 332, 1996.

  • 4.

    Cross M, Smith E, Hoy D, et al: The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73: 1323, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Farrokhi S, Chen YF, Piva SR, et al: The influence of knee pain location on symptoms, functional status, and knee-related quality of life in older adults with chronic knee pain: data from the osteoarthritis initiative. Clin J Pain 32: 463, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Farrokhi S, O’Connell M, Fitzgerald GK: Altered gait biomechanics and increased knee-specific impairments in patients with coexisting tibiofemoral and patellofemoral osteoarthritis. Gait Posture 41: 81, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Chou CH, Lee MT, Song IW, et al: Insights into osteoarthritis progression revealed by analyses of both knee tibiofemoral compartments. Osteoarthritis Cartilage 23: 571, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Duncan RC, Hay EM, Saklatvala J, et al: Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology 45: 757, 2006.

  • 9.

    Saito I, Okada K, Wakasa M, et al: Foot pressure pattern, hindfoot deformities, and their associations with foot pain in individuals with advanced medial knee osteoarthritis. Gait Posture 59: 83, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Guo M, Axe MJ, Manal K: The influence of foot progression angle on the knee adduction moment during walking and stair climbing in pain free individuals with knee osteoarthritis. Gait Posture 26: 436, 2007.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Levinger P, Menz HB, Fotoohabadi MR, et al: Foot posture in people with medial compartment knee osteoarthritis. J Foot Ankle Res 3: 29, 2010.

  • 12.

    Kamenaga T, Nakano N, Takayama K, et al: Comparison of plantar pressure distribution during walking and lower limb alignment between modified kinematically and mechanically aligned total knee arthroplasty. J Biomech 120: 110379, 2021.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Kubo T, Uritani D, Ogaya S, et al: Association between foot posture and tibiofemoral contact forces during barefoot walking in patients with knee osteoarthritis. BMC Musculoskelet Disord 23: 660, 2022.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Simic M, Wrigley TV, Hinman RS, et al: Altering foot progression angle in people with medial knee osteoarthritis: the effects of varying toe-in and toe-out angles are mediated by pain and malalignment. Osteoarthritis Cartilage 21: 1272, 2013.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Tan JM, Crossley KM, Munteanu SE, et al: Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis. J Foot Ankle Res 13: 57, 2020.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Guven M, Kocadal O, Akman B, et al: Pedobarographic analysis in total knee arthroplasty. J Knee Surg 30: 951, 2017.

  • 17.

    Callaghan MJ, Guney H, Reeves ND, et al: A knee brace alters patella position in patellofemoral osteoarthritis: a study using weight bearing magnetic resonance imaging. Osteoarthritis Cartilage 24: 2055, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Kellgren JH, Lawrence JS: Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16: 494, 1957.

  • 19.

    Lankhorst NE, Damen J, Oei EH, et al: Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee study. Osteoarthritis Cartilage 25: 647, 2017.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Iijima H, Fukutani N, Aoyama T, et al: Clinical impact of coexisting patellofemoral osteoarthritis in Japanese patients with medial knee osteoarthritis. Arthritis Care Res 68: 493, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    de Paula Lima PO, Camelo PRP, Ferreira V, et al: Evaluation of the isokinetic muscle function, postural control and plantar pressure distribution in capoeira players: a cross-sectional study. Muscles Ligaments Tendons J 7: 498, 2017.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Tuzun EH, Eker L, Aytar A, et al: Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 13: 28, 2005.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Cho Y, Ko Y, Lee W: Relationships among foot position, lower limb alignment, and knee adduction moment in patients with degenerative knee osteoarthritis. J Phys Ther Sci 27: 265, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Arnold JB, Wong DX, Jones RK, et al: Lateral wedge insoles for reducing biomechanical risk factors for medial knee osteoarthritis progression: a systematic review and meta-analysis. Arthritis Care Res 68: 936, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Abourazzak FE, Kadi N, Azzouzi H, et al: A positive association between foot posture index and medial compartment knee osteoarthritis in Moroccan people. Open Rheumatol J 8: 96, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Reilly KA, Louise Barker K, Shamley D, et al: Influence of foot characteristics on the site of lower limb osteoarthritis. Foot Ankle Int 27: 206, 2006.

  • 27.

    Reilly K, Barker K, Shamley D, et al: The role of foot and ankle assessment of patients with lower limb osteoarthritis. Physiotherapy 95: 164, 2009.

  • 28.

    Shull PB, Huang Y, Schlotman T, et al: Muscle force modification strategies are not consistent for gait retraining to reduce the knee adduction moment in individuals with knee osteoarthritis. J Biomech 48: 3163, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Rutherford DJ, Hubley-Kozey CL, Deluzio KJ, et al: Foot progression angle and the knee adduction moment: a cross-sectional investigation in knee osteoarthritis. Osteoarthritis Cartilage 16: 883, 2008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Wyndow N, Collins NJ, Vicenzino B, et al: Foot and ankle characteristics and dynamic knee valgus in individuals with patellofemoral osteoarthritis. J Foot Ankle Res 11: 65, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Lee TQ, Morris G, Csintalan RP: The influence of tibial and femoral rotation on patellofemoral contact area and pressure. J Orthop Sports Phys Ther 33: 686, 2003.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Hunt MA, Charlton JM, Krowchuk NM, et al: Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage 26: 903, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Farrokhi S, Piva SR, Gil AB, et al: Association of severity of coexisting patellofemoral disease with increased impairments and functional limitations in patients with knee osteoarthritis. Arthritis Care Res 65: 544, 2013.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Tan JM, Menz HB, Crossley KM, et al: The efficacy of foot orthoses in individuals with patellofemoral osteoarthritis: a randomised feasibility trial. Pilot Feasibility Stud 5: 90, 2019.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Zafar AQ, Zamani R, Akrami M: The effectiveness of foot orthoses in the treatment of medial knee osteoarthritis: A systematic review. Gait Posture 76: 238, 2020.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Lidtke RH, Muehleman C, Kwasny M, et al: Foot center of pressure and medial knee osteoarthritis. JAPMA 100: 178, 2010.

  • 37.

    Telarolli DJA, Grossi DB, Cervi ACC, et al: Comparison of foot kinematics and foot plantar area and pressure among five different closed kinematic tasks. JAPMA 110: 1, 2020.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Hart HF, Patterson BE, Crossley KM, et al: May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions-a systematic review and meta-analysis. Br J Sports Med 56: 521, 2022.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Willson JD, Ellis ED, Kernozek TW: Plantar loading characteristics during walking in females with and without patellofemoral pain. JAPMA 105: 1, 2015.

  • 40.

    Hart HF, Crossley KM, Hunt MA: Gait patterns, symptoms, and function in patients with isolated tibiofemoral osteoarthritis and combined tibiofemoral and patellofemoral osteoarthritis. J Orthop Res 36: 1666, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation

Altered Foot Progression Angle and Rearfoot Loading in Patellofemoral and Tibiofemoral Osteoarthritis: A Comparative Cross-Sectional Study

Nazli Busra Cigercioglu Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Turkey.

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 PT, PhD
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Zilan Bazancir-Apaydin Ankara Medipol University Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.

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 PT, PhD
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Gul Baltaci Istanbul Atlas University Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.

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Hande Guney-Deniz Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Turkey.

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Background: The purpose of this study was to investigate the differences in plantar loading distribution and functional levels between patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) patients, and to compare them with healthy individuals.

Methods: Sixty patients with knee osteoarthritis and 30 age-matched, healthy individuals (control group) were included in the study. The patients were divided into two groups, the PFOA group (n = 31) and the TFOA group (n = 29), based on the Kellgren Lawrence classification system. The maximum foot pressure of the foot (FPmax), forefoot weight ratio, rearfoot weight ratio, total load on foot, and foot progression angle (FPA) were determined by pedobarographic analysis. Functional level was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Results: There was a significant difference in FPA (F(2,79) = 22.322, P < .001) and rearfoot weight ratio (F(2,77) = 7.694, P = .001) among the groups. The FPA in the PFOA group was lower than in the TFOA group (P <. 001). The rearfoot weight ratio was higher in the PFOA group than in the TFOA group (P <. 05). No significant difference was found in FPmax (P = .457), forefoot weight ratio (P = .183), and total load on the foot (P = .226) among the groups. Also, no difference was found in the WOMAC total score and subscales between the PFAO and TFAO groups (P > .05).

Conclusions: The results suggest that the FPA and rearfoot loading were altered in patients with PFOA compared to those with TFOA and healthy individuals. Clinicians need to consider the effect of altered foot position and loading on the knee biomechanics in their treatment approach regarding foot orthoses or gait modification in patients with PFOA.

Corresponding author: Nazli Busra Cigercioglu, PT, PhD, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Hacettepe University, Anafartalar, Talatpasa Blvd No:47, 06100 Altindag/Ankara, Turkey. (E-mail: nazlicigercioglu@gmail.com)
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