Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(02): 235-243
DOI: 10.1055/s-0040-1713757
Artigo Original
Pé e Tornozelo

Avaliação funcional e de sintomatologia dolorosa do pé e tornozelo em indivíduos com obesidade grave – Estudo controlado transversal[*]

Article in several languages: português | English
Glaucus Cajaty Martins 
1   Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
3   Serviço de Estatística Médica, Hospital Universitário da Universidade Federal do Rio de Janeiro, RJ, Brasil
,
Pedro Henrique Gomes Fraga 
1   Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
,
Lucas Braga Teixeira 
1   Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
,
Bruno Rodrigues Guterres Valle 
1   Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
,
Luiz Felippe Martins Filho 
1   Serviço de Ortopedia e Traumatologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil
,
Maurício de Pinho Gama 
3   Serviço de Estatística Médica, Hospital Universitário da Universidade Federal do Rio de Janeiro, RJ, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Resumo

Objetivo Avaliar a prevalência de queixas álgicas no pé e tornozelo, parâmetros radiográficos e o desempenho funcional de indivíduos com obesidade grave, Índice de Massa Corpórea (IMC) com valor > 40 e indicação de cirurgia bariátrica.

Métodos Foram avaliados 40 pacientes com obesidade grave acompanhados em ambulatório de cirurgia bariátrica. Este grupo de obesos graves (IMC > 40) foi subdividido em dois subgrupos: obesos com IMC < 50 (n = 24); e outro de obesos com IMC > 50 (n = 16). Foi realizada comparação com grupo controle de 42 indivíduo voluntários com IMC médio de 24. Foram avaliados a presença de dor no pé pela escala visual (EVA), o desempenho funcional pela escala da Associação Americana de Cirurgia do Pé e Tornozelo (AOFAS, na sigla em inglês) (domínios antepé, mediopé e retropé), idade, gênero, ângulo (âng) metatarso-falangeano do hálux, âng intermetatarsal do hálux , âng talocalcaneano, “pitch” calcaneano e âng de Meary.

Resultados Foi observada maior incidência de dor no pé no grupo de obesos graves em relação ao controle (p < 0,0001, razão de chances [odds ratio, OR]: 4,2). O desempenho funcional pela escala AOFAS foi inferior no grupo de obesos em relação ao controle (p < 0,0001, retropé com OR = 4,81; mediopé com OR = 3,33).

Conclusão Houve maior incidência de dor no pé no grupo de obesos graves em relação ao controle. Houve pior desempenho funcional pela escala AOFAS nas regiões do antepé, mediopé e retropé no grupo de obesos graves.

Palavras-chave

pé - obesidade - dor - escala AOFAS

* Trabalho desenvolvido no Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil.




Publication History

Received: 08 August 2019

Accepted: 15 April 2020

Article published online:
29 October 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Thomas D, Elliott EJ. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database Syst Rev 2009; (01) CD006296
    PubMedGoogle Scholar
  • 2 Butterworth PA, Landorf KB, Smith SE, Menz HB. The association between body mass index and musculoskeletal foot disorders: a systematic review. Obes Rev 2012; 13 (07) 630-642
    CrossrefPubMedGoogle Scholar
  • 3 Harms S, Larson R, Sahmoun AE, Beal JR. Obesity increases the likelihood of total joint replacement surgery among younger adults. Int Orthop 2007; 31 (01) 23-26
    CrossrefPubMedGoogle Scholar
  • 4 Jinks C, Jordan K, Croft P. Disabling knee pain--another consequence of obesity: results from a prospective cohort study. BMC Public Health 2006; 6: 258
    CrossrefPubMedGoogle Scholar
  • 5 Martins GC, Martins Filho LF, Raposo AH, Gamallo RB, Menegazzi Z, Abreu AV. Radiographic evaluation and pain symptomatology of the knee in severely obese individuals - controlled transversal study. Rev Bras Ortop 2018; 53 (06) 740-746
    Google Scholar
  • 6 Mickle KJ, Steele JR. Obese older adults suffer foot pain and foot-related functional limitation. Gait Posture 2015; 42 (04) 442-447
    CrossrefPubMedGoogle Scholar
  • 7 Fabris SM, Faintuch J, Brienze SL. et al. Are knee and foot orthopedic problems more disabling in the superobese?. Obes Surg 2013; 23 (02) 201-204
    CrossrefPubMedGoogle Scholar
  • 8 Sowers M, Karvonen-Gutierrez CA, Palmieri-Smith R, Jacobson JA, Jiang Y, Ashton-Miller JA. Knee osteoarthritis in obese women with cardiometabolic clustering. Arthritis Rheum 2009; 61 (10) 1328-1336
    CrossrefPubMedGoogle Scholar
  • 9 Li H, George DM, Jaarsma RL, Mao X. Metabolic syndrome and components exacerbate osteoarthritis symptoms of pain, depression and reduced knee function. Ann Transl Med 2016; 4 (07) 133
    CrossrefPubMedGoogle Scholar
  • 10 Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994; 15 (07) 349-353
    CrossrefPubMedGoogle Scholar
  • 11 Menz H. Two feet, or one person? Problems associated with statistical analysis of paired data on foot and ankle medicine. Foot 2004; 14 (01) 2-5
    CrossrefGoogle Scholar
  • 12 Melo IT, São-Pedro M. Musculoskeletal pain in lower limbs in obese patients before and after bariatric surgery. Arq Bras Cir Dig 2012; 25 (01) 29-32
    CrossrefPubMedGoogle Scholar
  • 13 Walsh TP, Butterworth PA, Urquhart DM. et al. Increase in body weight over a two-year period is associated with an increase in midfoot pressure and foot pain. J Foot Ankle Res 2017; 10: 31
    CrossrefPubMedGoogle Scholar
  • 14 Gandhi R, Takahashi M, Smith H, Rizek R, Mahomed NN. The synovial fluid adiponectin-leptin ratio predicts pain with knee osteoarthritis. Clin Rheumatol 2010; 29 (11) 1223-1228
    CrossrefPubMedGoogle Scholar
  • 15 Kalichman L, Li L, Kobyliansky E. Prevalence, pattern and determinants of radiographic hand osteoarthritis in Turkmen community-based sample. Rheumatol Int 2009; 29 (10) 1143-1149
    CrossrefPubMedGoogle Scholar
  • 16 de Mello AP, Martins GCDS, Heringer AR. et al. Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery. Eur Spine J 2019; 28 (05) 967-975
    CrossrefPubMedGoogle Scholar
  • 17 Dumond H, Presle N, Terlain B. et al. Evidence for a key role of leptin in osteoarthritis. Arthritis Rheum 2003; 48 (11) 3118-3129
    CrossrefPubMedGoogle Scholar
  • 18 Abdel-Fattah MM, Hassanin MM, Felembane FA, Nassaane MT. Flat foot among Saudi Arabian army recruits: prevalence and risk factors. East Mediterr Health J 2006; 12 (1-2): 211-217
    PubMedGoogle Scholar
  • 19 Otsuka R, Yatsuya H, Miura Y. et al. [Association of flatfoot with pain, fatigue and obesity in Japanese over sixties]. Nippon Koshu Eisei Zasshi 2003; 50 (10) 988-998
    PubMedGoogle Scholar
  • 20 Kinds MB, Welsing PM, Vignon EP. et al. A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee. Osteoarthritis Cartilage 2011; 19 (07) 768-778
    CrossrefPubMedGoogle Scholar
  • 21 Frilander H, Viikari-Juntura E, Heliövaara M, Mutanen P, Mattila VM, Solovieva S. Obesity in early adulthood predicts knee pain and walking difficulties among men: A life course study. Eur J Pain 2016; 20 (08) 1278-1287
    CrossrefPubMedGoogle Scholar
  • 22 Frey C, Zamora J. The effects of obesity on orthopaedic foot and ankle pathology. Foot Ankle Int 2007; 28 (09) 996-999
    CrossrefPubMedGoogle Scholar
  • 23 Cho NH, Kim S, Kwon DJ, Kim HA. The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg Br 2009; 91 (04) 494-498
    CrossrefPubMedGoogle Scholar
  • 24 Nguyen US, Hillstrom HJ, Li W. et al. Factors associated with hallux valgus in a population-based study of older women and men: the MOBILIZE Boston Study. Osteoarthritis Cartilage 2010; 18 (01) 41-46
    CrossrefPubMedGoogle Scholar
  • 25 Menz HB, Dufour AB, Casey VA. et al. Foot pain and mobility limitations in older adults: the Framingham Foot Study. J Gerontol A Biol Sci Med Sci 2013; 68 (10) 1281-1285
    CrossrefPubMedGoogle Scholar