Aoife MacMahon1, Howard J Hillstrom2, Huong T Do3, Jeremy Y Chan1, Jonathan T Deland1, Scott J Ellis1. 1. Department of Foot and Ankle Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA. 2. Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA. 3. Department of Epidemiology and Biostatistics, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Abstract
BACKGROUND: Intraoperative pedobarography has the potential to aid surgical decisions, but no parameters exist to guide its use. QUESTIONS/PURPOSES: This study compared supine plantar pressures between flatfoot patients and controls using a previously validated intraoperative pedobarographic device and examined associations between supine, walking, and standing plantar pressures. METHODS: Ten preoperative patients with stage II adult-acquired flatfoot deformity (AAFD) were compared to ten healthy controls. Supine plantar pressures were assessed using the pedobarographic device. Standing and walking plantar pressures were assessed with an EMED-XT sensor array (Novel). Maximum force (MF) and peak pressure (PP) were calculated for nine anatomical foot regions adjusting for age and BMI. RESULTS: No differences in plantar pressures were found between flatfoot patients and controls in the supine or standing positions. During walking, flatfoot patients had greater MF of the first, second, and third metatarsals (p ≤ 0.018) and greater PP of the first and second metatarsals than controls (p ≤ 0.010). Supine MF and PP were both strongly positively correlated with their respective pressure measurements for both standing and walking in multiple foot regions (p ≤ 0.05, all analyses). Correlations in the first metatarsal region were generally weak and not statistically significant. CONCLUSION: This device did not show differences in supine plantar pressures of flatfoot patients and healthy subjects, highlighting the limitations of intraoperative devices in guiding flatfoot correction. The differences between flatfoot and controls during walking and the correlations between supine and walking conditions suggest that dynamic plantar pressures are a more useful parameter in guiding flatfoot reconstruction.
BACKGROUND: Intraoperative pedobarography has the potential to aid surgical decisions, but no parameters exist to guide its use. QUESTIONS/PURPOSES: This study compared supine plantar pressures between flatfoot patients and controls using a previously validated intraoperative pedobarographic device and examined associations between supine, walking, and standing plantar pressures. METHODS: Ten preoperative patients with stage II adult-acquired flatfoot deformity (AAFD) were compared to ten healthy controls. Supine plantar pressures were assessed using the pedobarographic device. Standing and walking plantar pressures were assessed with an EMED-XT sensor array (Novel). Maximum force (MF) and peak pressure (PP) were calculated for nine anatomical foot regions adjusting for age and BMI. RESULTS: No differences in plantar pressures were found between flatfoot patients and controls in the supine or standing positions. During walking, flatfoot patients had greater MF of the first, second, and third metatarsals (p ≤ 0.018) and greater PP of the first and second metatarsals than controls (p ≤ 0.010). Supine MF and PP were both strongly positively correlated with their respective pressure measurements for both standing and walking in multiple foot regions (p ≤ 0.05, all analyses). Correlations in the first metatarsal region were generally weak and not statistically significant. CONCLUSION: This device did not show differences in supine plantar pressures of flatfoot patients and healthy subjects, highlighting the limitations of intraoperative devices in guiding flatfoot correction. The differences between flatfoot and controls during walking and the correlations between supine and walking conditions suggest that dynamic plantar pressures are a more useful parameter in guiding flatfoot reconstruction.
Authors: Mostafa M Abousayed; Jason P Tartaglione; Andrew J Rosenbaum; John A Dipreta Journal: Clin Orthop Relat Res Date: 2016-02 Impact factor: 4.176
Authors: Jeremy Y Chan; Stephen T Greenfield; Dylan S Soukup; Huong T Do; Jonathan T Deland; Scott J Ellis Journal: Foot Ankle Int Date: 2015-07-27 Impact factor: 2.827
Authors: Reinhard Schuh; Florian Salzberger; Axel H Wanivenhaus; Philipp T Funovics; Reinhard Windhager; Hans-Joerg Trnka Journal: J Orthop Res Date: 2012-11-28 Impact factor: 3.494