The Effect of Arch Drop on Tibial Rotation and Tibiofemoral Contact Stress in Postpartum Women

Abstract

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Increase in tibial internal rotation due to weight-bearing is a key feature to diagnose early-stage knee osteoarthritis: a study with upright computed tomography

“…In the past, it has been reported that ACL function declines by 20% between people in their 20s and 80s, and aging may be one of the reasons for ACL dysfunction [ 27 ]. In another upright cone-beam CT, arch drop was found to cause internal rotation of the tibia in a group of women at high risk for knee OA [ 28 ]. This suggests that tibial internal rotation may be a risk factor for more severe knee OA.…”

The Association of Parity with Greater Dynamic Pronation of the Feet

“…Srikanth et al previously reported that women are at increased risk of knee OA 4 and planus feet have been associated with medial tibiofemoral cartilage damage 15 . Greater pronation of the foot causes increased rotation of the tibia, 26 which can be transferred through the knee to the femur and is a characteristic of women who have lost arch height with pregnancy 20 . Salsich et al found that participants with patellofemoral pain syndrome with a medial collapse movement fault had higher tibiofemoral rotation 27 and Kalichman et al found that patellar malalignment was associated with patellofemoral OA 28 .…”

“…15 Greater pronation of the foot causes increased rotation of the tibia, 26 which can be transferred through the knee to the femur and is a characteristic of women who have lost arch height with pregnancy. 20 Salsich et al found that participants with patellofemoral pain syndrome with a medial collapse movement fault had higher tibiofemoral rotation 27 and Kalichman et al found that patellar malalignment was associated with patellofemoral OA. 28 Thus, increased pronation of the foot during walking (lower CPEI) in those with higher parity potentially could lead to increased articular contact stress at the knee and more proximal joints, which could partially explain the increased risk for knee OA in women.…”

“…7 Segal et al found that arch collapse persists following pregnancy to at least 19 weeks postpartum in 40%-60% of women, and in a follow-up study, 11 of the women from the original study with 19-week follow-up had persistent foot length/width and arch changes greater than 1 year after the original study. 20 Planus foot posture has been associated with more eversion excursion than rectus foot posture in runners 16 and may lead to excessive pronation of the foot during both standing and walking activities. 20 A recent study showed that foot pronation in women may cause kinematic changes that are transmitted to more proximal structures, resulting in low back pain.…”

“…20 Planus foot posture has been associated with more eversion excursion than rectus foot posture in runners 16 and may lead to excessive pronation of the foot during both standing and walking activities. 20 A recent study showed that foot pronation in women may cause kinematic changes that are transmitted to more proximal structures, resulting in low back pain. 21 Therefore, persistent changes in dynamic foot function and foot biomechanics due to pregnancy may affect loading and motion patterns of more proximal structures in the kinetic chain.…”