Efficacy of a New Ankle Foot Orthosis on Knee Adduction Moment and Clinical Parameters in Individuals with Medial Knee Osteoarthritis

2021 ◽  
Author(s):  
Kourosh Barati ◽  
Alireza Shamsoddini
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Adduction Moment ◽  
Clinical Parameters ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

scholarly journals Effect of an ankle–foot orthosis on knee joint mechanics: A novel conservative treatment for knee osteoarthritis

2013 ◽  
Vol 38 (6) ◽  
pp. 481-491 ◽  
Author(s):  
Cynthia H Fantini Pagani ◽  
Steffen Willwacher ◽  
Rita Benker ◽  
Gert-Peter Brüggemann
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Varus Alignment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Ankle Foot Orthosis ◽  
Lever Arm ◽  
Foot Orthosis

Background: Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success. Objective: To analyze the effect of an ankle–foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment. Study design: Controlled laboratory study, repeated measurements. Methods: In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle–foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis. Results: Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle–foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles. Conclusion: The ankle–foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane. Clinical relevance This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis.

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

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.

Effects of knee orthosis adjustment on biomechanical performance and clinical outcome in patients with medial knee osteoarthritis

2017 ◽  
Vol 41 (6) ◽  
pp. 587-594 ◽  
Author(s):  
Andreas Brand ◽  
Isabella Klöpfer-Krämer ◽  
Mario Morgenstern ◽  
Inga Kröger ◽  
Björn Michel ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Clinical Effectiveness ◽  
Knee Adduction Moment ◽  
Force Transmission ◽  
Pain Sensation ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Good Patient Compliance ◽  
Gait Function

Background: Valgus bracing in medial knee osteoarthritis aims to improve gait function by reducing the loading of the medial compartment. Orthosis composition and optimal adjustment is essential to achieve biomechanical and clinical effectiveness. Objectives: To investigate biomechanical functionality during gait, pain relief and compliance in patients with knee osteoarthritis using a lightweight adjustable knee unloader orthosis. Study Design: Prospective observational clinical trial. Methods: Instrumented gait analysis in 22 patients with unilateral medial knee osteoarthritis was performed after a 2-week orthosis acclimatisation period. Kinematics and kinetics during gait as well as force transmission from the orthosis to the knee were analysed. Measurements were performed without, at individualised and at reduced orthosis setting. The assessment was supplemented by patient-related pain sensation and compliance questionnaires. Results: Orthosis wear significantly reduced the knee adduction moment by up to 20% depending on orthosis adjustment, whereas pain sensation was significantly reduced by 16%. A significant positive correlation was found between force transmissions and knee adduction moment as well as for frontal knee angle. Compliance was good with a main daily use of 2–6 h. Conclusion: The orthosis provides significant biomechanical improvements, pain relief and good patient compliance. Patients had a biomechanical benefit for the individualised and reduced orthosis adjustments. Clinical relevance In patients with medial knee osteoarthritis, a lightweight medial unloader orthosis effectively reduced external knee adduction moment and pain sensation during daily activities. Thus, use of lightweight orthoses effectively supports conservative treatment in medial knee osteoarthritis.

scholarly journals Effect of real-time biofeedback on peak knee adduction moment in patients with medial knee osteoarthritis: Is direct feedback effective?

2018 ◽  
Vol 57 ◽  
pp. 150-158 ◽  
Author(s):  
Rosie E. Richards ◽  
Josien C. van den Noort ◽  
Martin van der Esch ◽  
Marjolein J. Booij ◽  
Jaap Harlaar
Keyword(s):  
Knee Osteoarthritis ◽  
Real Time ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Direct Feedback

scholarly journals Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis

2017 ◽  
Vol 57 ◽  
pp. 177-181 ◽  
Author(s):  
Tomonori Sawada ◽  
Kenji Tanimoto ◽  
Kazuki Tokuda ◽  
Yoshitaka Iwamoto ◽  
Yuta Ogata ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Adduction Moment ◽  
Foot Kinematics ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Foot Alignment

scholarly journals Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis

2009 ◽  
Vol 33 (2) ◽  
pp. 107-116 ◽  
Author(s):  
Robert J. Butler ◽  
Joaquin A. Barrios ◽  
Todd Royer ◽  
Irene S. Davis
Keyword(s):  
Knee Osteoarthritis ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Orthotic Devices ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Wedge Condition ◽  
Foot Orthotic

The purpose of this study was to examine the effects of laterally wedged foot orthotic devices, used to treat knee osteoarthritis, on frontal plane mechanics at the rearfoot and hip during walking. Thirty individuals with diagnosed medial knee osteoarthritis were recruited for this study. Three dimensional kinematics and kinetics were recorded as the subjects walked in the laboratory at an intentional walking speed. Peak eversion, eversion excursion and peak eversion moment were increased while the peak knee adduction moment was reduced in the laterally wedged orthotic condition compared to the no wedge condition. In contrast, no changes were observed in the variables of interest at the hip. There was no significant relationship between the change in the peak frontal plane moment at the rearfoot and change in the peak frontal plane moment at the knee or hip as a result of the lateral wedge. Laterally wedged foot orthotic devices, used to treat knee osteoarthritis, do not influence hip mechanics. However, they do result in increased rearfoot eversion and inversion moment. Therefore, a full medical screen of the foot should occur before laterally wedged foot orthotic devices are prescribed as a treatment for knee osteoarthritis.

Sign in / Sign up

Export Citation Format

Share Document