Effects of Disease Severity on Response to Lateral Wedged Shoe Insole for Medial Compartment Knee Osteoarthritis

Abstract 

Shimada S, Kobayashi S, Wada M, Uchida K, Sasaki S, Kawahara H, Yayama T, Kitade I, Kamei K, Kubota M, Baba H. Effects of disease severity on response to lateral wedged shoe insole for medial compartment knee osteoarthritis.

Objective

To determine the effects of lateral wedged insoles on knee kinetics and kinematics during walking, according to radiographic severity of medial compartment knee osteoarthritis (OA).

Design

A prospective case control study of patients with medial compartment OA of the knee.

Setting

Gait analysis laboratory in a university hospital.

Participants

Forty-six medial compartment knees with OA of 23 patients with bilateral disease and 38 knees of 19 age-matched healthy subjects as controls.

Interventions

Not applicable.

Main Outcome Measures

We measured the peak external adduction moment at the knee during the stance phase of gait and the first acceleration peak after heel strike at the lateral side of the femoral condyles. Kellgren and Lawrence grading system was used for radiographic assessment of OA severity.

Results

The mean value of peak external adduction moment of the knee was higher in OA knees than the control. Application of lateral wedged insoles significantly reduced the peak external adduction moment in Kellgren-Lawrence grades I and II knee OA patients. The first acceleration peak value after heel strike in these patients was relatively high compared with the control. Application of lateral wedged insoles significantly reduced the first acceleration peak in Kellgren-Lawrence grades I and II knee OA patients.

Conclusions

The kinetic and kinematic effects of wearing of lateral wedged insoles were significant in Kellgren-Lawrence grades I and II knee OA. The results support the recommendation of use of lateral wedged insoles for patients with early and mild knee OA.

Key Words: Gait, Orthotic devices, Osteoarthritis, Rehabilitation