背景:中足骨关节炎(OA)是一种常见病,然而,它的病因并不清楚。了解有和没有中足OA的人之间足底压力的差异可能会提供对病因的了解以及如何最好地管理这种情况。
目的:比较有和没有症状的X线照相中足OA患者的足底压力。
方法:这是一项对50岁以上的成年人进行的横断面研究,这些成年人在过去的一年中接受了4项英国全科医生的报告。症状性X线片中足OA定义为过去四周中足疼痛,与一个或多个足中关节的影像学OA结合。病例的性别和年龄(±5岁)与对照组1:1匹配。使用压力平台确定了足部10个区域的最大足底压力和最大力(RSscanInternational,奥伦,比利时),并使用独立样本t检验和效应大小(科恩d)在组间进行比较。
结果:我们包括61例中足OA病例(平均年龄67.0,SD8.1,男性31,30名女性),并将其与61名对照(平均年龄66.0,SD7.9)相匹配。中足OA病例显示更大的力(d=0.79,中等效应大小,p=<0.001)和中足压力(d=0.70,中等效应大小,p=<0.001),第四meta趾(MTP)关节处的力更大(d=0.28,小效应大小,p=0.13),和第五个MTP关节(d=0.37,效应大小小,p=0.10)和第五个MTP关节处的更大压力(d=0.34,效应大小小,p=0.13)。它们还显示出较低的力(d=0.40,效应大小小,p=0.02)和拇指处的压力(d=0.50,中等效果大小,p=<0.001)和较低的力(d=0.54,中等效应大小,p=<0.001)和小脚趾处的压力(d=0.48,小效应大小,与对照组相比,p=<0.001)。
结论:中足OA似乎与内侧纵弓的降低有关,更大的横向推力和更少的推进在脚趾。需要纵向研究来建立因果关系。
Midfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without
midfoot OA may provide insight into the aetiology and how best to manage this condition.
To compare plantar pressures between people with and without symptomatic radiographic midfoot OA.
This was a cross-sectional
study of adults aged ≥ 50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic
midfoot OA was defined as
midfoot pain in the last four weeks, combined with radiographic OA in one or more
midfoot joints. Cases were matched 1:1 for sex and age ( ± 5 years) to controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t-tests and effect sizes (Cohen\'s d).
We included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d=0.79, medium effect size, p = <0.001) and pressure at the midfoot (d=0.70, medium effect size, p = <0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d=0.28, small effect size, p = 0.13), and fifth MTP joint (d=0.37, small effect size, p = 0.10) and greater pressure at the fifth MTP joint (d=0.34, small effect size, p = 0.13). They also displayed lower force (d=0.40, small effect size, p = 0.02) and pressure at the hallux (d=0.50, medium effect size, p = <0.001) and lower force (d=0.54, medium effect size, p = <0.001) and pressure at the lesser toes (d=0.48, small effect size, p = <0.001) compared with controls.
Midfoot OA appears to be associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships.