Effects of common footwear on joint loading in osteoarthritis of the knee
Article first published online: 26 FEB 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 7, pages 917–923, July 2010
How to Cite
Shakoor, N., Sengupta, M., Foucher, K. C., Wimmer, M. A., Fogg, L. F. and Block, J. A. (2010), Effects of common footwear on joint loading in osteoarthritis of the knee. Arthritis Care Res, 62: 917–923. doi: 10.1002/acr.20165
- Issue published online: 29 JUN 2010
- Article first published online: 26 FEB 2010
- Manuscript Accepted: 17 FEB 2010
- Manuscript Received: 4 DEC 2008
- NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases). Grant Numbers: 1-P50-AR048941, K23-AR049748
Elevated joint loads during walking have been associated with the severity and progression of osteoarthritis (OA) of the knee. Footwear may have the potential to alter these loads. This study compares the effects of several common shoe types on knee loading in subjects with OA of the knee.
Thirty-one subjects (10 men, 21 women) with radiographic and symptomatic knee OA underwent gait analyses using an optoelectronic camera system and multicomponent force plate. In each case, gait was evaluated during barefoot walking and while wearing 4 different shoe types: 1) clogs, 2) stability shoes, 3) flat walking shoes, and 4) flip-flops. Peak knee loads were compared between the different footwear conditions.
Overall, the clogs and stability shoes resulted in a significantly higher (∼15% higher) peak knee adduction moment (mean ± SD 3.1 ± 0.7 and 3.0 ± 0.7 divided by body weight [BW] × height [H] multiplied by 100, respectively; P < 0.05) compared with that of flat walking shoes (mean ± SD 2.8 ± 0.7 %BW × H), flip-flops (mean ± SD 2.7 ± 0.8 %BW × H), and barefoot walking (mean ± SD 2.7 ± 0.7 %BW × H). There were no statistically significant differences in knee loads with the flat walking shoes and flip-flops compared with barefoot walking.
These data confirm that footwear may have significant effects on knee loads during walking in subjects with OA of the knee. Flexibility and heel height may be important differentiating characteristics of shoes that affect knee loads. In light of the strong relationship between knee loading and OA, the design and biomechanical effects of modern footwear should be more closely evaluated in terms of their effects on the disease.