Dr. Karen Kruger, research associate professor in the Marquette University and Medical College of Wisconsin Joint Department of Biomedical Engineering, has received an R01 grant from the National Institutes of Health with an anticipated value of $3.2 million to complete a comprehensive study of the 3D structure and function of pediatric flat feet throughout growth and development.
Kruger will form a consortium with colleagues from the University of Utah; University of California, Davis; University of Nebraska Medical Center; and the Medical College of Wisconsin to assess weightbearing computed tomography (WBCT), and its ability to provide 3D radiographic imaging, for use in developing children. It will also continue the longstanding collaboration between the Orthopaedic and Rehabilitation Engineering Center at Marquette and Shriners Children’s, which provided the preliminary data for this study. The long-term focus of this project is to provide a more comprehensive assessment of the 3D structure and function of flat foot structure in children and allow for accurate clinical assessment and targeted treatment planning.
“The foot is a complex structure and severe deformities such as flat feet are common among children, with reported incidence as high as 44% of children,” Kruger said. “Weightbearing computed tomography is an emerging technology and has been called a ‘game-changer’ due to its ability to observe pathologies in the adult foot previously not able to be seen. Despite the successes and changes in clinical paradigms resulting from its technological advances, applications have been limited to adult foot deformity and have not been translated to pediatric populations. This has created a large knowledge gap in our understanding of foot pathologies throughout growth and development.”
The overall objective of the consortium will be a multisite project to perform a comprehensive study of the 3D structure and function of flat feet in children with two specific aims. First, researchers will complete a cross-sectional evaluation of children with flat feet using current standard-of-care 2D radiographic analysis and equivalent metrics obtained from 3D WBCT. The second aim will be a longitudinal evaluation of children with flat feet to determine radiographic and functional metrics that are predictive of worsening symptoms and arch collapse.
Improved assessment of weightbearing foot structures in combination with dynamic gait data in children with foot deformities will allow for a more informed decision-making process for clinicians providing care, ranging from tone management, orthotics prescription and surgical interventions.
“This is a remarkable project that will bring new technology and knowledge to pediatric care, made possible by Dr. Karen Kruger’s collaborative leadership across multiple institutions and with the support of NIH,” said Dr. Kristina Ropella, Opus Dean of the Opus College of Engineering. “I am inspired by Dr. Kruger’s ability to build on Marquette’s legacy of collaboration with Shriners, MCW and research partners around the world. She is a true servant leader who is making a difference for clinicians and families.”
Partnering with Kruger in this consortium are Dr. Amy Lenz, assistant professor of mechanical engineering at Utah; Dr. Amanda Whitaker, M.D., assistant professor at the UC Davis Medical Center; Dr. Jessica Fritz, assistant professor in orthopaedic surgery at MCW; and Dr. Kevin Dibbern, assistant professor in pediatrics at the Nebraska Medical Center.
