Moderate-Heeled Shoes and Knee Joint Torques Relevant to the Development and Progression of Knee Osteoarthritis

Abstract 

Kerrigan DC, Johansson JL, Bryant MG, Boxer JA, Della Croce U, Riley PO. Moderate-heeled shoes and knee joint torques relevant to the development and progression of knee osteoarthritis.

Objective

To determine if women’s dress shoes with heels of just 1.5in (3.8cm) in height increases knee joint torques, which are thought to be relevant to the development and/or progression of knee osteoarthritis (OA) in both the medial and patellofemoral compartments.

Design

Randomized controlled trial.

Setting

A 3-dimensional motion analysis gait laboratory.

Participants

Twenty-nine healthy young women (age, 26.7±5.0y) and 20 healthy elderly adult women (age, 75.3±6.5y).

Interventions

Not applicable.

Main outcome measures

Peak external varus knee torque in early and late stance and prolongation of flexor knee torque in early stance. Three-dimensional data on lower-extremity torques and motion were collected during walking while (1) wearing shoes with 1.5-in high heels and (2) wearing control shoes without any additional heel. Data were plotted and qualitatively compared; major peak values and timing were statistically compared between the 2 conditions using paired t tests.

Results

Peak knee varus torque during late stance was statistically significantly greater with the heeled shoes than with the controls, with increases of 14% in the young women and 9% in the elderly women. With the heeled shoes, the early stance phase knee flexor torque was significantly prolonged, by 19% in the young women and by 14% in elderly women. Also, the peak flexor torque was 7% higher with the heeled shoe in the elderly women.

Conclusions

Even shoes with moderately high heels (1.5in) significantly increase knee torques thought to be relevant in the development and/or progression of knee OA. Women, particularly those who already have knee OA, should be advised against wearing these types of shoes.

Key words:  Biomechanics , Gait , Kinetics , Knee , Osteoarthritis , Rehabilitation , Shoes , Women