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Efficacy of pedobarographic analysis to evaluate proximal medial gastrocnemius recession in patients with gastrocnemius tightness and metatarsalgia

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Abstract

Purpose

Proximal medial gastrocnemius recession (PMGR) is a surgical procedure performed in patients with gastrocnemius tightness (GT). The purpose of this study is to evaluate the efficacy of pedobarographic analysis on PMGR in patients with GT and metatarsalgia.

Methods

This prospective study included 52 patients diagnosed with GT treated surgically with PMGR and 49 non-operated upon patients (control group). A total of 55 PMGRs (three bilateral) were performed as an isolated or combined procedure in the treatment group. Passive ankle dorsiflexion with knee flexion and extension was evaluated in all patients. In addition, pedobarographic analysis was performed before and after surgery.

Results

Median preoperative ankle dorsiflexion was −10.0° (equinus) with extended knee and 10.0° with flexed knee and postoperative differences in median ankle dorsiflexion was 12.5° (extended knee) (p = 0.000) and 5.0° (flexed knee) (p = 0.002). After the PMGR, the median area of the contact surface (−3.0 cm2) (p = 0.009), the maximum (−13,239.0 Pa) (p = 0.019) and mean pressure (−2,942.0 Pa) and the forefoot force (−70.0 N) (p = 0.000) decreased. An increase in hindfoot force (20.0 N), hindfoot bearing time (4.0 ms) (p = 0.005), and forefoot bearing time (1.0 ms) was also observed.

Conclusions

Pedobarographic analysis is an efficient tool to evaluate surgical procedures that assess metatarsal overload. PMGR is an effective surgical procedure to improve passive ankle range of motion and decrease forefoot plantar overload.

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References

  1. Chimera NJ, Castro M, Manal K (2010) Function and strength following gastrocnemius recession for isolated gastrocnemius contracture. Foot Ankle Int 31:377–384

    Article  PubMed  Google Scholar 

  2. Pinney SJ, Hansen ST Jr, Sangeorzan BJ (2002) The effect on ankle dorsiflexion of gastrocnemius recession. Foot Ankle Int 23:26–29

    Article  PubMed  Google Scholar 

  3. Gurdezi S, Kohls-Gatzoulis J, Solan MC (2013) Results of proximal medial gastrocnemius release for Achilles tendinopathy. Foot Ankle Int 34:1364–1369

  4. Barouk LS, Barouk P (2012) Gastrocnemios cortos. Rev Pie y Tobillo 2:7–13

    Article  Google Scholar 

  5. Gentchos CE, Bohay DR, Anderson JG (2008) Gastrocnemius recession as treatment for refractory Achilles tendinopathy: a case report. Foot Ankle Int 29:620–623

  6. Abbassian A, Kohls-Gatzoulis J, Solan MC (2012) Proximal medial gastrocnemius release in the treatment of recalcitrant plantar fasciitis. Foot Ankle Int 33:14–19

    Article  PubMed  Google Scholar 

  7. Greenhagen RM, Johnson AR, Peterson MC, Rogers LC, Bevilacqua NJ (2010) Gastrocnemius recession as an alternative to tendoAchillis lenghtening for relief of forefoot pressure in a patient with periphereal neuropathy: a case report and description of a technical modification. J Foot Ankle Surg 49:159.e9–159.e13

  8. Barske HL, DiGiovanni BF, Douglass M, Nawoczenski DA (2012) Current concepts review: isolated gastrocnemius contracture and gastrocnemius recession. Foot Ankle Int 33:915–921

    Article  PubMed  Google Scholar 

  9. Chen WM, Park J, Park SB, Shim VP, Lee T (2012) Role of gastrocnemius-soleus muscle in forefoot force transmission at heel rise—a 3D finite element analysis. J Biomech 45:1783–1789

    Article  PubMed  Google Scholar 

  10. Maskill JD, Bohay DR, Anderson JG (2010) Gastrocnemius recession to treat isolated foot pain. Foot Ankle Int 31:19–23

    Article  PubMed  Google Scholar 

  11. Aronow MS, Diaz-Doran V, Sullivan RJ, Adams DJ (2006) The effect of triceps surae contracture force on plantar foot pressure distribution. Foot Ankle Int 27:43–52

    Article  PubMed  Google Scholar 

  12. Barouk LS, Barouk P (eds) (2012) Gastrocnemios Cortos: De la Anatomía al tratamiento. Sauramps Medical, Montpellier

  13. Myerson M, Barouk P (eds) (2014) The gastrocnemius. Elsevier, Philadelphia

  14. Lasserre G, Cornu JY, Vidal C, Laveaux C, Lepage D, Obert L, Pauchot J, Tropet Y (2011) Baropodometric analysis of the functional donor-site morbidity after gastrocnemius or soleus muscle-flap procedure. Ann Chir Plast Esthet 563:180–193

    Article  Google Scholar 

  15. Molund M, Paulsrud O, Ellingsen Husebye E, Nilsen F, Hvaal K (2014) Results after gastrocnemius recession in 73 patients. Foot Ankle Surg 20:272–275

    Article  PubMed  Google Scholar 

  16. Boone DC, Azen SP, Lin CM, Spence C, Baron C, Lee L (1978) Reliability of goniometric measurements. Phys Ther 58:11355–11360

    Google Scholar 

  17. Mutlu A, Livanelioglu A, Gunel MK (2007) Reliability of goniometric measurements in children with spastic cerebral palsy. Med Sci Monit 13(7):CR323–CR329

    PubMed  Google Scholar 

  18. Saro C, Andrén B, Felländer-Tsai L, Lindgren U, Arndt A (2007) Plantar pressure distribution and pain after distal osteotomy for hallux valgus. A prospective study of 22 patients with 12-month follow-up. Foot 17(2):84–93

    Article  Google Scholar 

  19. Borton DC, Stephens MM (1994) Basal metatarsal osteotomy for hallux valgus. J Bone Joint Surg Br 76:204–209

    CAS  PubMed  Google Scholar 

  20. Lau JTC, Stamatis ED, Parks BG, Schon LC (2004) Modifications of the Weil osteotomy have no effect on plantar pressure. Clin Orthop Relat Res 421:194–198

    Article  Google Scholar 

  21. Snyder J, Owen J, Wayne J, Adelaar R (2005) Plantar pressure and load in cadaver feet after a Weil or chevron osteotomy. Foot Ankle Int 26:158–165

    Article  PubMed  Google Scholar 

  22. Vandeputte G, Dereymaeker G, Steenwerckx A, Peeraer L (2000) The Weil osteotomy of the lesser metatarsals: a clinical and pedobarographic follow-up study. Foot Ankle Int 21(5):370–374

    Article  CAS  PubMed  Google Scholar 

  23. Arvikar R, Seireg A (1980) A pressure distribution under the foot during static activities. Eng Med 9:99–103

    Article  Google Scholar 

  24. Martínez-Nova A, Cuevas-García JC, Sánchez-Rodríguez R, Pascual-Huerta J, Sánchez-Barrado E (2008) Estudio del patrón de presiones plantares en pies con hallux valgus mediante un sistema de plantillas instrumentadas. Rev Esp Cir Ortop Traumatol 52(2):94–98

    Google Scholar 

  25. Martínez-Nova A, Sánchez-Rodríguez R, Cuevas-García JC, Sánchez-Barrado E (2007) Estudio baropodométrico de los valores de presión plantar en pies no patológicos. Rehabilitacion 41(4):155–160

    Article  Google Scholar 

  26. Martinelli L, Hurschler C, Rosenbaum D (2006) Comparison of capacitive versus resistive joint contact stress sensors. Clin Orthop Relat Res 447(447):214–220

    Article  CAS  PubMed  Google Scholar 

  27. Giacomozzi C (2010) Appropriateness of plantar pressure measurement devices: a comparative technical assessment. Gait Posture 32(1):141–144

    Article  PubMed  Google Scholar 

  28. Toullec E (2012) Baropodometria y acortamiento de los gastrocnemios. In: Barouk LS, Barouk P (eds) Gastrocnemios Cortos: De la Anatomía al tratamiento. Sauramps Medical, Montpellier

    Google Scholar 

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Acknowledgements

We want to thank Álvaro De Pablos and Juan Carlos Léo for their assistance in performing the pedobarographic studies and providing the results of the pedobarographic analysis. We also want to thank Jordan Carolina Villa for the English correction of this manuscript.

Funding

There is no funding source to declare.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Navarra, Spain

    Gustavo Vinagre, Matías Alfonso & Carlos Villas

  2. Department of Orthopaedic Surgery and Traumatology, Clínica San Miguel, Pamplona, Navarra, Spain

    Sebastián Cruz-Morande

  3. Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Navarra, Spain

    Miguel Hernández

Authors
  1. Gustavo Vinagre
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  2. Matías Alfonso
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  3. Sebastián Cruz-Morande
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  4. Miguel Hernández
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  5. Carlos Villas
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Corresponding author

Correspondence to Gustavo Vinagre.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The Clínica Universidad de Navarra approved this study, and written informed consent was obtained from all patients before surgical treatment including that the data may be included in future publications.

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Vinagre, G., Alfonso, M., Cruz-Morande, S. et al. Efficacy of pedobarographic analysis to evaluate proximal medial gastrocnemius recession in patients with gastrocnemius tightness and metatarsalgia. International Orthopaedics (SICOT) 41, 2281–2287 (2017). https://doi.org/10.1007/s00264-017-3621-0

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  • DOI: https://doi.org/10.1007/s00264-017-3621-0

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