ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1667271
Foot Progression Angle Asymmetry as a Potential Biomechanical Marker of Radiographic Severity in Knee Osteoarthritis
Provisionally accepted
- 1Tianjin University Tianjin Hospital, Tianjin, China
- 2Dehong Prefecture People's Hospital, Mangshi, China
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Introduction: Knee osteoarthritis (OA) induces asymmetric gait adaptations, yet the role of foot progression angle (FPA) remains unquantified. This study aimed to: (1) compare FPA differences between affected and contralateral limbs in knee OA patients, (2) characterize FPA asymmetry patterns, and (3) identify factors associated with inter-limb FPA differences. Methods: FPA asymmetry was quantified in 127 patients scheduled for unilateral high tibial osteotomy (HTO). FPA was measured bilaterally during natural walking. Multivariable logistic regression identified factors associated with asymmetry patterns. Results: FPA was significantly larger on contralateral limbs versus affected limbs (15.21°±7.72° vs. 11.38°±8.13°, *p*<0.001). Adjusted for covariates, patients with Kellgren-Lawrence (K&L) grade 1/2 OA had 70.2% lower odds (OR=0.298, 95%CI:0.091–0.982) and grade 3 OA had 76.2% lower odds (OR=0.238, 95%CI:0.081–0.700) of exhibiting contralateral-dominant FPA asymmetry compared to grade 4 OA (P<0.05). Conclusion: Knee OA patients exhibit FPA asymmetry characterized by greater toe-out on the contralateral limb, correlating positively with higher radiographic severity (K&L grade) in the affected knee. FPA asymmetry may serve as a potential biomechanical marker of OA severity.
Keywords: knee osteoarthritis, gait asymmetry, foot progression angle, Compensatory mechanism, Radiographic severity
Received: 16 Jul 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Dai, Ma, Lu, Bai, Zhang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jian-Xiong Ma, Tianjin University Tianjin Hospital, Tianjin, China
Xinlong Ma, Tianjin University Tianjin Hospital, Tianjin, China
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