Are differences in leg length predictive of lateral patello‐femoral pain?

Carlson, Mary; Wilkerson, Jerry D.

doi:10.1002/pri.351

Cited by 20 publications

(8 citation statements)

References 35 publications

(45 reference statements)

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“…It has been implicated as a cause of a variety of medical conditions, including low back pain, trochanteric bursitis, osteoarthritis of the hip and knee, knee pain, and running injuries such as Achilles rupture. (2-10)…”

Section: Introductionmentioning

confidence: 99%

Association of Leg-Length Inequality With Knee Osteoarthritis

et al. 2010

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Background Leg length inequality is common in the general population and may accelerate development of knee osteoarthritis. Objective To determine if leg length inequality is associated with prevalent, incident and progressive knee osteoarthritis, Design Prospective observational cohort study. Setting Subjects recruited from the community in Birmingham, AL and Iowa City, IA Patients 3026 subjects, age 50-79, with or at high risk for knee osteoarthritis. Measurements The exposure was leg length inequality measured from full limb radiographs. The outcomes were prevalent, incident, and progressive knee osteoarthritis. Radiographic osteoarthritis was defined as Kellgren and Lawrence grade ≥2 and symptomatic osteoarthritis was defined as radiographic disease in a consistently painful knee. Results Leg length inequality ≥1 cm was associated with prevalent radiographic (53% vs. 36%, OR 1.9, 95%CI 1.5-2.4) and symptomatic (30% vs. 17%, OR 2.0, 95%CI 1.6-2.6) osteoarthritis in the shorter limb. Inequality ≥1 cm was associated with incident symptomatic osteoarthritis in the shorter (15% vs. 9%, OR 1.7, 95%CI 1.2-2.4) and longer (13% vs. 9%, OR 1.5, 95%CI 1.0-2.1) limb. Inequality ≥1 cm was associated with increased odds (29% vs. 24%, OR 1.3, 95%CI 1.0-1.7) of progressive osteoarthritis in the shorter limb. Limitations The duration of follow-up may not be long enough to adequately identify cases of incidence and progression. Measurements of leg length, including radiographic, have measurement error which could result in misclassification. Conclusions Radiographic leg length inequality was associated with prevalent, incident symptomatic and progressive knee osteoarthritis. These results point to leg length inequality as a potentially modifiable risk factor for knee osteoarthritis. Primary Funding Source National Institute on Aging

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Section: Introductionmentioning

confidence: 99%

Association of Leg-Length Inequality With Knee Osteoarthritis

et al. 2010

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“…5,6 Asymmetry in the kinetics of LLD-induced gait has also been linked to the etiology of plantar fasciitis, 7 lower back pain 8 and knee pain. 9 Concretely, LLD may play a key role in skeletal malalignment disorders such as patellofemoral conditions. 10 Asymmetries in the kinematics of human gait have been correlated with different degrees of anatomical LLD, 5 such as pelvic drop and hip adduction in the stance phase.…”

Section: Introductionmentioning

confidence: 99%

Intra and intersession repeatability and reliability of dynamic parameters in pressure platform assessments on subjects with simulated leg length discrepancy. A cross-sectional research

Pereiro‐Buceta

Calvo‐Lobo

Becerro-de-Bengoa-Vallejo

et al. 2021

Sao Paulo Med. J.

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BACKGROUND: Leg length discrepancy (LLD) may play a key role in exercise biomechanics. Although the Podoprint platform has been used in dynamic pressure studies, there are no data regarding the reliability and repeatability of dynamic measurements under simulated LLD conditions. OBJECTIVES: To determine the intra and intersession repeatability and reliability of dynamic parameters of the Podoprint pressure platform under simulated LLD conditions. DESIGN AND SETTING: Observational cross-sectional study at a public university. METHODS: Thirty-seven healthy volunteers participated in this study. LLD was simulated using ethyl vinyl acetate plantar lifts with heights of 5 mm, 10 mm, 15 mm and 20 mm located under the right shoe of each volunteer. The procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Stance time, mean pressure and peak pressure measurements were registered in three trials for each foot and each LLD level. Data were collected during two separate testing sessions, in order to establish intrasession and intersession reliability. RESULTS: The intraclass correlation coefficients (ICCs) for intrasession reliability ranged from 0.775 to 0.983 in the first session and from 0.860 to 0.985 in the second session. The ICCs for intersession reliability ranged from 0.909 to 0.990. Bland-Altman plots showed absence of systematic measurement errors. CONCLUSIONS: The results from this study indicate that the Podoprint platform is a reliable system for assessing dynamic parameters under simulated LLD conditions. Future studies should evaluate plantar pressures under LLD conditions, in association with exercise, biomechanics and musculoskeletal disorders.

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“…Anatomic limb length discrepancy (ALLD) has been related to different orthopedic conditions, such as posterior tibial tendon dysfunction and hip osteoarthritis, due to an inadequate distribution of mechanical loads, 1,2 as well as gait kinematics asymmetries resulted from ALLD have been related to plantar fasciitis, 3 low back pain, 4 and anterior knee pain. 5 On the other hand, some studies have shown that limb length discrepancy (LLD) lower than 35 mm would not have a hazardous outcome in both function and etiology of orthopedic conditions. [6][7][8] Khamis and Carmeli 9 suggested that the controversy regarding the role of LLD on orthopedic conditions is related to the poor validity of measurement methods and the several abnormal biomechanical alterations that could be caused by LLD.…”

Section: Introductionmentioning

confidence: 99%

Dynamic leg length asymmetry during gait is not a valid method for estimating mild anatomic leg length discrepancy

Leporace

Batista

Cruz

et al. 2018

Journal of Orthopaedics

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The purpose of this study was to test the validity of dynamic leg length discrepancy (DLLD) during gait as a radiation-free screening method for measuring anatomic leg length discrepancy (ALLD). Thirty-three subjects with mild leg length discrepancy walked along a walkway and the dynamic leg length discrepancy (DLLD) was calculated using a motion analysis system. Pearson correlation and paired Student -tests were applied to calculate the correlation and compare the differences between DLLD and ALLD (α = 0.05). The results of our study showed DLLD is not a valid method to predict ALLD in subjects with mild limb discrepancy.

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Are differences in leg length predictive of lateral patello‐femoral pain?

Abstract: The results suggested that the PALM method of measuring leg length differences may have clinical utility in differentiating between patients who are likely to sustain patello-femoral pain syndrome and those who will not.

Cited by 20 publications

References 35 publications

Association of Leg-Length Inequality With Knee Osteoarthritis

Association of Leg-Length Inequality With Knee Osteoarthritis

Intra and intersession repeatability and reliability of dynamic parameters in pressure platform assessments on subjects with simulated leg length discrepancy. A cross-sectional research

Dynamic leg length asymmetry during gait is not a valid method for estimating mild anatomic leg length discrepancy

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