Alteration of foot loading pattern in patients with lower limb endoprothesis surgery and functional outcome: A pilot study

IntroductionEndoprosthetic reconstruction is a widely used technique; however, it is associated with various postoperative complications. One often overlooked complication is the alteration of foot loading patterns. This pilot study evaluated functional outcomes with postoperative static foot loading patterns in patients undergoing endoprosthesis replacements compared to the contralateral limb.ObjectiveThis study evaluates static foot loading patterns in patients undergoing endoprosthetic replacements. It explores the relationship between the functional outcomes of the operated limb and foot loading patterns in a standing position. Additionally, the study considers factors such as the anatomical location of the endoprosthetic reconstruction, limb length discrepancy, age, gender, and body mass index (BMI).Materials and MethodsThis prospective cross-sectional study included 100 patients over 15 years who had undergone lower limb endoprosthetic reconstruction at least 1 year prior and could walk unaided. Data collection encompassed patient demographics, diagnosis, anthropometric measurements, postoperative functional status (evaluated using AOFAS-Hindfoot, MSTS, and TESS scores), and postoperatively analysis of foot loading patterns.ResultsThe patient group has a significantly higher prevalence of abnormal foot arches compared to the expected population proportion. Notably, 10% of patients transitioned from a normal arch to flatfoot, while 40% developed a high arch post-surgery. Asymmetrical arches were observed in 30 patients. Post-surgery, 18.5% of patients experienced a transition from a normal foot arch to a high arch, and 4.6% transitioned to flatfoot. Analysis of variables such as surgical site, limb length discrepancy, age, gender, BMI, foot loading patterns and functional scores (MSTS, TESS and AOFAS) showed no significant associations with these changes.ConclusionAlthough no significant correlation was identified between functional scores and foot loading patterns following lower limb endoprosthetic surgery, a notable prevalence of abnormal foot arches was observed. We recommend routine podiatry consultations for these patients to address and manage potential foot-related complications.