The mapping of plantar callosity formations, patterns and distributions: their application to total hip arthroplasty

Abstract

Painful feet caused by plantar callosities may affect physical mobility and, as physical mobility hastens rehabilitation following Total Hip Replacement (THR) surgery painful plantar callosities may detrimentally affect the rehabilitation process. There is, however, no evidence at this time to suggest that THR recipients are adversely affected by plantar callosities. Indeed, the NAO (2003) report ‘Total Hip Replacement: An Update’ stated that multidisciplinary teams of health professionals should be engaged in the rehabilitation process, but podiatrists were not mentioned.

Before any trials can be undertaken with patients following THR, procedures for the mapping for callosities are required. This mapping will assist in the identification of abnormalities before and after THR and subsequently the times for any podiatric intervention. This map consists of four variables: callosity measurements; foot pressure captured from discrete anatomical sites; limb length discrepancy (LLD) and footedness/sidedness (f/s). As this is a new area of investigation, each of the measurement tools used to determine the reliability and usability were piloted. These pilot investigations used a population of twenty male and female participants aged over 40 years without any disabilities.

Callosity measurements were determined by tracing thirty callosities and then using planimetry to calculate their surface areas. Thirty footsteps were captured on a foot pressure system and the reliability of the recognition of the first and second metatarsal heads were assessed. Twenty left and right lower limbs were measured using a flexible steel rule from the superior anterior iliac spine to the lateral malleolus. A four task f/s functional characteristic inventory was completed by twenty participants to assess manipulation, mobilisation and stability of the lower limb.

The statistical analyses of each of these measurement tools used showed high levels of reliability. Small alterations were made to the measurement systems so making it suitable for any future clinical investigation with THR recipients. This thesis presents the four pilot investigations together with a discussion of the clinical application of this work to THR recipients.

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Identifiers

ORCID for Lisa Roberts: orcid.org/0000-0003-2662-6696

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