Effect of lateral wedged insoles on the knee internal contact forces in medial knee osteoarthritis

Medial knee loading during stair negotiation in individuals with medial knee osteoarthritis has only been reported in terms of joint moments, which may underestimate the knee loading. This study assessed knee contact forces (KCF) and contact pressures during different stair negotiation strategies. Motion analysis was performed in 5 individuals with medial knee osteoarthritis (52.8 [11.0] y) and 8 healthy subjects (51.0 [13.4] y) while ascending and descending a staircase. KCF and contact pressures were calculated using a multibody knee model while performing step-over-step at controlled and self-selected speed, and step-by-step strategies. At controlled speed, individuals with osteoarthritis showed decreased peak KCF during stair ascent but not during stair descent. Osteoarthritis patients showed higher trunk rotations in frontal and sagittal planes than controls. At lower self-selected speed, patients also presented reduced medial KCF during stair descent. While performing step-by-step, medial contact pressures decreased in osteoarthritis patients during stair descent. Osteoarthritis patients reduced their speed and increased trunk flexion and lean angles to reduce KCF during stair ascent. These trunk changes were less safe during stair descent where a reduced speed was more effective. Individuals should be recommended to use step-over-step during stair ascent and step-by-step during stair descent to reduce medial KCF.

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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

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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.

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