Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Effect of Chronic Foot Disease to Bone Mineral Density of the Affected Lower Limb

만성 족부 질환이 환측 하지의 골밀도에 미치는 영향

  • Chu, In-Tak (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Yoo, Jong-Min (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kang, Min-Gu (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Chung, Jin-Wha (Department of Orthopaedic Surgery, Yeouido St. Mary’s Hospital, The Catholic University of Korea School of Medicine)
  • 주인탁 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 유종민 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 강민구 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 정진화 (가톨릭대학교 의과대학 여의도성모병원 정형외과)
  • Received : 2010.10.28
  • Accepted : 2010.11.18
  • Published : 2010.12.15
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Abstract

Purpose: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. Materials and Methods: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. Results: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p <0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p <0.05). Conclusion: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.

Keywords

References

  1. Kai MC, Anderson M, Lau EM. Exercise interventions: defusing the world's osteoporosis time bomb. Bull World Health Organ. 2003;81:827-30.
  2. Lingard EA, Mitchell SY, Francis RM, et al. The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty. Age Ageing. 2010;39:234-9. https://doi.org/10.1093/ageing/afp222
  3. Favier FB, Benoit H, Freyssenet D. Cellular and molecular events controlling skeletal muscle mass in response to altered use. Pflugers Arch. 2008;456:587-600. https://doi.org/10.1007/s00424-007-0423-z
  4. Damiano J. Diagnostic procedures for painful foot. Rev Prat. 2010;60:327-33.
  5. Voronov ML, Pinzur MS, Hoffman HH, et al. Static measure of foot loading. Foot Ankle Spec. 2009;2:267-70. https://doi.org/10.1177/1938640009349451
  6. Keegan TH, Kelsey JL, Sidney S, Quesenberry CP Jr. Foot problems as risk factors of fractures. Am J Epidemiol. 2002;155:926-31. https://doi.org/10.1093/aje/155.10.926
  7. Sievanen H. Immobilization and bone structure in humans. Arch Biochem Biophys. 2010;503:146-52. https://doi.org/10.1016/j.abb.2010.07.008
  8. Akhter MP, Alvarez GK, Cullen DM, Recker RR. Disuserelated decline in trabecular bone structure. Biomech Model Mechanobiol. 2010;Aug 4. [Epub ahead of print]
  9. Horisberger M, Hintermann B, Valderrabano V. Alterations of plantar pressure distribution in posttraumatic end-stage ankle osteoarthritis. Clin Biomech (Bristol, Avon). 2009;24:303-7. https://doi.org/10.1016/j.clinbiomech.2008.12.005
  10. Newton MT, Archer JA, Scruggs M, et al. Low bone mass and fractures on foot radiographs: missed opportunities to evaluate for osteophorosis: a pilot study. J Am Podiatr Med Assoc. 2009;99:1-7.
  11. Ferretti, JL, Cointry GR, Capozza RF, Frost HM. Bone mass, bone strength, muscle-bone interactions, osteopenias and osteoporoses. Mech Ageing Dev. 2003;124:269-79. https://doi.org/10.1016/S0047-6374(02)00194-X
  12. Cohen MM Jr. The new bone biology: pathologic, molecular, and clinical correlates. Am J Med Genet A. 2006;140:2646-706.
  13. Ralston SH. Genetics of osteoporosis. Proc Nutr Soc. 2007;66:158-65.
  14. van den Bergh JP, van Geel TA, Lems WF, Geusens PP. Assessment of individual fracture risk: FRAX and beyond. Curr Osteoporos Rep. 2010;8:131-7. https://doi.org/10.1007/s11914-010-0022-3
  15. van Helden S, van Geel AC, Geusens PP, et al. Bone and fall-related fracture risks in women and men with a recent clinical fracture. J Bone Joint Surg Am. 2008;90:241-8. https://doi.org/10.2106/JBJS.G.00150
  16. Nguyen T, Sambrook P, Kelly P, et al. Prediction of osteoporotic fractures by postural instability and bone density. Br Med J 1993;307:1111-5. https://doi.org/10.1136/bmj.307.6912.1111