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Published in: HSS Journal ® 2/2017

01-07-2017 | Original Article

In Vivo Plantar Pressures in Adult-Acquired Flatfoot Compared to Control Using an Intraoperative Pedobarographic Device

Authors: Aoife MacMahon, BA, Howard J. Hillstrom, PhD, Huong T. Do, MA, Jeremy Y. Chan, MD, Jonathan T. Deland, MD, Scott J. Ellis, MD

Published in: HSS Journal ® | Issue 2/2017

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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.
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Literature
3.
go back to reference Chan JY, Greenfield ST, Soukup DS, Do HT, Deland JT, Ellis SJ. Contribution of Lateral Column Lengthening to Correction of Forefoot Abduction in Stage IIb Adult Acquired Flatfoot Deformity Reconstruction. Foot Ankle Int. 2015. doi: 10.1177/1071100715596607. Chan JY, Greenfield ST, Soukup DS, Do HT, Deland JT, Ellis SJ. Contribution of Lateral Column Lengthening to Correction of Forefoot Abduction in Stage IIb Adult Acquired Flatfoot Deformity Reconstruction. Foot Ankle Int. 2015. doi: 10.​1177/​1071100715596607​.
4.
go back to reference Conti MS, Chan JY, Do HT, Ellis SJ, Deland JT. Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity. Foot Ankle Int. 2015. doi: 10.1177/1071100714564217. Conti MS, Chan JY, Do HT, Ellis SJ, Deland JT. Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity. Foot Ankle Int. 2015. doi: 10.​1177/​1071100714564217​.
5.
go back to reference Deland JT, Page A, Sung I-H, O’Malley MJ, Inda D, Choung S. Posterior tibial tendon insufficiency results at different stages. HSS J Musculoskelet J Hosp Spec Surg. 2006; 2: 157-160. doi:10.1007/s11420-006-9017-0. Deland JT, Page A, Sung I-H, O’Malley MJ, Inda D, Choung S. Posterior tibial tendon insufficiency results at different stages. HSS J Musculoskelet J Hosp Spec Surg. 2006; 2: 157-160. doi:10.​1007/​s11420-006-9017-0.
7.
go back to reference Ellis SJ, Stoecklein H, Yu JC, Syrkin G, Hillstrom H, Deland JT. The accuracy of an automasking algorithm in plantar pressure measurements. HSS J Musculoskelet J Hosp Spec Surg. 2011; 7: 57-63. doi:10.1007/s11420-010-9185-9. Ellis SJ, Stoecklein H, Yu JC, Syrkin G, Hillstrom H, Deland JT. The accuracy of an automasking algorithm in plantar pressure measurements. HSS J Musculoskelet J Hosp Spec Surg. 2011; 7: 57-63. doi:10.​1007/​s11420-010-9185-9.
8.
go back to reference Haleem AM, Pavlov H, Bogner E, Sofka C, Deland JT, Ellis SJ. Comparison of Deformity with Respect to the Talus in Patients with Posterior Tibial Tendon Dysfunction and Controls Using Multiplanar Weight-Bearing Imaging or Conventional Radiography. J Bone Jt Surg Am. 2014; 96: e63. doi:10.2106/JBJS.L.01205.CrossRef Haleem AM, Pavlov H, Bogner E, Sofka C, Deland JT, Ellis SJ. Comparison of Deformity with Respect to the Talus in Patients with Posterior Tibial Tendon Dysfunction and Controls Using Multiplanar Weight-Bearing Imaging or Conventional Radiography. J Bone Jt Surg Am. 2014; 96: e63. doi:10.​2106/​JBJS.​L.​01205.CrossRef
9.
10.
go back to reference Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop. 1989;196–206. Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop. 1989;196–206.
11.
go back to reference Matheis EA, Spratley EM, Hayes CW, Adelaar RS, Wayne JS. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity. J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. 2014; 53: 562-566. doi:10.1053/j.jfas.2014.03.020. Matheis EA, Spratley EM, Hayes CW, Adelaar RS, Wayne JS. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity. J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. 2014; 53: 562-566. doi:10.​1053/​j.​jfas.​2014.​03.​020.
12.
go back to reference Menz HB, Fotoohabadi MR, Munteanu SE, Zammit GV, Gilheany MF. Plantar pressures and relative lesser metatarsal lengths in older people with and without forefoot pain. J Orthop Res. 2013; 31: 427-433. doi:10.1002/jor.22229.CrossRefPubMed Menz HB, Fotoohabadi MR, Munteanu SE, Zammit GV, Gilheany MF. Plantar pressures and relative lesser metatarsal lengths in older people with and without forefoot pain. J Orthop Res. 2013; 31: 427-433. doi:10.​1002/​jor.​22229.CrossRefPubMed
15.
go back to reference Richter M. Technique for Intraoperative Use of Pedography. Tech Foot Ankle Surg. 2006; 5: 88-100.CrossRef Richter M. Technique for Intraoperative Use of Pedography. Tech Foot Ankle Surg. 2006; 5: 88-100.CrossRef
17.
go back to reference Richter M, Zech S. Is intraoperative pedography helpful in clinical use--preliminary results of 100 cases from a consecutive, prospective, randomized, controlled clinical study. Foot Ankle Surg Off J Eur Soc Foot Ankle Surg. 2009; 15: 198-204. doi:10.1016/j.fas.2009.03.002.CrossRef Richter M, Zech S. Is intraoperative pedography helpful in clinical use--preliminary results of 100 cases from a consecutive, prospective, randomized, controlled clinical study. Foot Ankle Surg Off J Eur Soc Foot Ankle Surg. 2009; 15: 198-204. doi:10.​1016/​j.​fas.​2009.​03.​002.CrossRef
19.
20.
go back to reference Schuh R, Salzberger F, Wanivenhaus AH, Funovics PT, Windhager R, Trnka H-J. Kinematic changes in patients with double arthrodesis of the hindfoot for realignment of planovalgus deformity. J Orthop Res Off Publ Orthop Res Soc. 2013; 31: 517-524. doi:10.1002/jor.22269.CrossRef Schuh R, Salzberger F, Wanivenhaus AH, Funovics PT, Windhager R, Trnka H-J. Kinematic changes in patients with double arthrodesis of the hindfoot for realignment of planovalgus deformity. J Orthop Res Off Publ Orthop Res Soc. 2013; 31: 517-524. doi:10.​1002/​jor.​22269.CrossRef
Metadata
Title
In Vivo Plantar Pressures in Adult-Acquired Flatfoot Compared to Control Using an Intraoperative Pedobarographic Device
Authors
Aoife MacMahon, BA
Howard J. Hillstrom, PhD
Huong T. Do, MA
Jeremy Y. Chan, MD
Jonathan T. Deland, MD
Scott J. Ellis, MD
Publication date
01-07-2017
Publisher
Springer US
Published in
HSS Journal ® / Issue 2/2017
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-017-9542-z

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