Foot pressure distribution in patients with gonarthrosis.

BACKGROUND: When standing, leg alignment is controlled by supinating or pronating the subtalar joint, corresponding to valgus or varus deformity of the knee joint. However, in the gait cycle, it is not clear whether the abnormal alignment can be compensated. OBJECTIVE: The purpose of this study was to evaluate the control of leg alignment in the latter half of the gait cycle. METHODS: Forty-six patients (46ft) with unilateral gonarthrosis (16 men, 30 women; mean age, 69 years) were evaluated for foot pressure distributions of the forefoot and midfoot. The apparatus used was a walkway in which a tactile force- and pressure-measurement system was installed. Patients were classified by femorotibial angle, pronation-supination index (PSI), foot pressure distribution of the point of the metatarsal head, and passage point of the center of pressure (COP) at the toe. RESULTS: A larger femorotibial angle was associated with a larger PSI, and contact such that the load is applied more strongly to the pressure points of the metatarsal heads laterally. In addition, with a larger femorotibial angle, COP at the toe tended to pass through the second toe. In other words, foot sole contact is significantly more lateral with varus knee, whereas foot sole contact tends to be more medial with valgus knee. CONCLUSIONS: Analysis revealed that severe abnormal leg alignment was not sufficiently compensated for by the forefoot and midfoot in the latter half of the gait cycle. When treating the forefoot and midfoot, precautions are necessary in patients with knee deformities.

Subcutaneous Achilles tendon rupture in an eighty-year-old female with an absence of risk factors.

Achilles tendon ruptures rarely occur in patients over 80 years of age. However, it is unclear what treatment, surgical or conservative, is suitable for such an Achilles tendon rupture in the elderly. In addition, the clinical results of an Achilles tendon rupture in the elderly are disappointing. We report here the case of a subcutaneous Achilles tendon rupture in an eighty-year-old, healthy female, who returned to her previous level of activity following surgical treatment. Additional case reports of other instances of successful treatment are needed to help establish the optimal treatment protocol for an Achilles tendon rupture in the elderly.

Factors influencing the improvement of gait ability after total hip arthroplasty.

We aimed to investigate the factors influencing gait improvement in the patients who had undergone total hip arthroplasty. We performed gait analysis on 43 female patients with unilateral hip osteoarthritis. All the patients were analyzed before and at 2, 6, and 12 months after the surgery. There were significant reductions in spatiotemporal parameters in the patients with hip osteoarthritis compared with the control group. The mean values of the spatiotemporal parameters of the patients showed considerable improvement by 12 months after surgery; however, they did not reach the same values as those observed in the healthy subjects. The stage of osteoarthritis and the changes in the leg-length discrepancies were the factors that most influenced gait improvement after total hip arthroplasty throughout the follow-up period.