Abnormal foot pressure in older adults with knee osteoarthritis: a systematic review

P. Panyarachun, C. Angthong, P. Jindasakchai, P. Rajbhandari, N. Rungrattanawilai

Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand. chatthara@yahoo.com

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• Orthopedics

OBJECTIVE: Knee osteoarthritis (KOA) is a progressive disease affecting the biomechanics of the knee and other parts of the lower extremities, such as the ankle and foot. Little is known about the pathophysiology of plantar pressure in patients with KOA, which could lead to foot disability. This review aimed to provide more in-depth information regarding the pathophysiology of plantar pressure patterns and their related parameters in older adults with KOA.

MATERIALS AND METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed database was searched with the keywords “foot pressure and knee osteoarthritis” and “center of pressure and knee osteoarthritis”. The eligible articles were evaluated based on five characteristics: KOA stages, sample size, country, study tool, and findings. The primary outcomes were plantar pressure and center of pressure (COP) in each area. Other outcomes were also evaluated, such as knee flexion angle, knee abductor moment, and clinical scores.

RESULTS: Nine full-text articles were eligible for review, including 495 participants (256 patients with KOA and 239 healthy individuals). The mean age of patients with KOA was 60.2-77 years. Patients with KOA had a higher tendency for pronounced plantar pressure on the medial forefoot, mid-foot, or the foot’s central area. The COP patterns were shorter and more lateralized in patients with KOA, reflecting the functional ability, pain, and well-being of patients with KOA.

CONCLUSIONS: Abnormalities in plantar pressure and COP were observed in older adults with KOA. This information could be a basis for designing biomedical devices, orthoses, and other realignment osteotomies of the lower extremities that could relieve symptoms at the knee or foot, or reduce KOA progression.

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