Foot Pressure Pattern and its Correlation With Knee Range of Motion Limitations for Individuals With Medial Knee Osteoarthritis

Background:Patients suffering from mild-to-moderate medial compartment knee osteoarthritis may be treated with an unloader knee orthosis. However, compliance has been shown to be an issue with such devices.Objectives:The aim of this study was to identify the effects of a new design of knee unloader orthosis on specific gait parameters in patients with mild-to-moderate medial knee osteoarthritis.Methods:The gait of seven patients was assessed in two conditions: without an orthosis and when wearing a new design of unloader knee orthosis. Gait analysis was performed to determine alterations to the adduction moment, speed of walking, step length, cadence and knee sagittal plane range of motion during ambulation for the two test conditions.Results:The knee adduction moment was significantly reduced ( p = 0.001), and the speed of walking significantly increased ( p < 0.001) when wearing the orthosis. However, a reduction in knee range of motion ( p = 0.002) and an increase in step length ( p < 0.001) were observed with the orthosis donned. Cadence was not significantly altered ( p = 0.504).Conclusion:The use of a new design of unloader knee orthosis as a conservative treatment approach for patients with mild-to-moderate medial compartment osteoarthritis appears warranted.Clinical relevanceVarious conservative modalities have been used to reduce pain and improve function in medial compartment osteoarthritis. A new design of an unloader knee orthosis has been developed and is shown to have immediate benefits in patients with mild medial knee osteoarthritis.

Download Full-text

Effect of lateral-wedge insole on the center of foot pressure and lower extremity muscle activity at gait initiation in patients with medial knee osteoarthritis

Journal of Physical Therapy Science ◽

10.1589/jpts.31.776 ◽

2019 ◽

Vol 31 (10) ◽

pp. 776-779

Author(s):

Hiroshi Katoh

Keyword(s):

Lower Extremity ◽

Knee Osteoarthritis ◽

Muscle Activity ◽

Gait Initiation ◽

Foot Pressure ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Lower Extremity Muscle ◽

Center Of Foot Pressure

Download Full-text

Comparison of Clinical and Biomechanical Outcomes between Partial Fibulectomy and Drug Conservative Treatment for Medial Knee Osteoarthritis

BioMed Research International ◽

10.1155/2019/4575424 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Guo Chen ◽

Bin Xu ◽

Jinwei Xie ◽

Yong Nie ◽

Shuo Tang ◽

...

Keyword(s):

Conservative Treatment ◽

Knee Osteoarthritis ◽

Range Of Motion ◽

Pain Score ◽

Controlled Study ◽

Knee Score ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Peak Knee ◽

Flexion Extension

Background. Upper partial fibulectomy has been preliminarily proved to have the efficacy for pain alleviation and improvement of function in patients with mild to moderate medial compartment knee osteoarthritis (KOA). However, the previous studies lack the control group with other treatments. The aim of this prospective, randomized controlled study is to compare the clinical and biomechanical effects between upper partial fibulectomy and drug conservative treatment on improvement of clinical pain, function, and gait for patients with mild to moderate medial knee osteoarthritis (KOA) and further discuss its biomechanical mechanism. Methods. From August 2016 to February 2017, 49 and 48 patients with mild to moderate medial KOA were allocated to fibulectomy and drug groups. We assessed the patients’ visual analog scale (VAS) pain score, Hospital for Special Surgery (HSS) knee score, limb alignment, passive flexion/extension range of motion (ROM) of the knee, and 3D gait kinematics and kinetics parameters before and after intervention. Repeated-measures ANOVA with Dunnett’s post hoc assessment and multivariate analysis of variance were applied for intragroup and intergroup comparisons, respectively. Results. The improvement in the fibulectomy group on the VAS pain score, HSS knee score, walking speed, and walking knee range of motion (ROM) was statistically better than that in the drug group. The decreased overall peak knee adduction moment (KAM) (decreased by 16.1%) and hip-knee-ankle (HKA) angle (decreased by 0.99° from a more varus alignment to a more neutral alignment) of the affected and operated side 1 year after surgery were observed in the fibulectomy group. Conclusion. This research demonstrated that as a biomechanical intervention, upper partial fibulectomy can be a better choice in pain relief and function and gait improvement than drug conservative treatment for patients with early-stage knee OA. The long-term clinical outcomes, indication, and rationale for the improvement in clinical symptoms should be investigated further.

Download Full-text

Responses to gait retraining using pressure-based auditory feedback for medial knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.02.111 ◽

2021 ◽

Vol 29 ◽

pp. S81-S82

Author(s):

J. He ◽

C. Ferrigno ◽

N. Shakoor ◽

M.A. Wimmer

Keyword(s):

Knee Osteoarthritis ◽

Auditory Feedback ◽

Gait Retraining ◽

Medial Knee ◽

Medial Knee Osteoarthritis

Download Full-text

A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

Clinical Rehabilitation ◽

10.1177/0269215521993636 ◽

2021 ◽

pp. 026921552199363

Author(s):

Martin Schwarze ◽

Leonie P Bartsch ◽

Julia Block ◽

Merkur Alimusaj ◽

Ayham Jaber ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Controlled Trial ◽

Oxford Knee Score ◽

Knee Adduction Moment ◽

Osteoarthritis Of The Knee ◽

Knee Score ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Patient Reported ◽

Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

Download Full-text