Inconsistent knee varus moment reduction caused by a lateral wedge in knee osteoarthritis

Wataru Kakihana, Masami Akai, Kimitaka Nakazawa, Kenji Naito, Suguru Torii

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE: To determine-with the assistance of a larger sample size-whether the inconsistency of reducing the knee-joint varus moment with a lateral wedge in patients with medial compartment knee osteoarthritis (OA) persists and if so, what underlying mechanisms may explain it. DESIGN: Crossover design whereby 51 patients with bilateral isolated medial compartment knee OA and 19 age-matched healthy controls walked with two different wedge conditions: a 0-degree control wedge and a 6-degree lateral wedge. We conducted three-dimensional motion analysis, hip-knee-ankle (HKA) angle measurement, and radiologic assessment with Kellgren-Lawrence grade. We investigated frontal plane angles and moments at the knee and subtalar joints, ground reaction forces, and center of pressure (CoP). Moments were derived using a three-dimensional inverse dynamics model of the lower extremity. RESULTS: Nine patients (17.6%) had an increased knee-joint varus moment with the 6-degree lateral wedge via the medially shifted location of the CoP. These patients did not differ from the remaining patients in HKA angle and radiologic assessment. CONCLUSION: In approximately 18% of patients with bilateral medial compartment knee OA, the 6-degree lateral wedge seems to fail to reduce the knee-joint varus moment. The indication and limitations of lateral wedge should be confirmed by a randomized controlled study.

Original languageEnglish
Pages (from-to)446-454
Number of pages9
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume86
Issue number6
DOIs
Publication statusPublished - 2007 Jun 1

Keywords

  • Biomechanics
  • Osteoarthritis
  • Rehabilitation
  • Shoes

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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