Mechanical effectiveness of lateral foot wedging in medial knee osteoarthritis after 1 year of wear

Authors

  • Joaquin A. Barrios,

    Corresponding author
    1. Department of Health and Sports Science, University of Dayton, 300 College Park, Dayton, Ohio 45469-2925
    • Department of Health and Sports Science, University of Dayton, 300 College Park, Dayton, Ohio 45469-2925. T: 937-229-5609; F: 937-229-5601
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  • Robert J. Butler,

    1. Duke University Medical Center, Doctor of Physical Therapy Division, DUMC 104002, Durham, North Carolina 27705
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  • Jeremy R. Crenshaw,

    1. Department of Orthopaedic Surgery, Mayo Clinic, 200 1st Street SW, Charlton North L-110F, Rochester, Minnesota 55905
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  • Todd D. Royer,

    1. Department of Health, Nutrition and Exercise Science, University of Delaware, 144 Rust Ice Arena, 541 South College Avenue, Newark, Delaware 19716
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  • Irene S. Davis

    1. Department of Physical Medicine and Rehabilitation, Harvard Medical School, 1575 Cambridge Street, Cambridge, Massachusetts 02138
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Abstract

The use of lateral foot wedging in the management of medial knee osteoarthritis is under scrutiny. Interestingly, there have been minimal efforts to evaluate biomechanical effectiveness with long-term use. Therefore, we aimed to evaluate dynamic knee loading (assessed using the knee adduction moment) and other secondary gait parameters in patients with medial knee osteoarthritis wearing lateral foot wedging at a baseline visit and after 1 year of wear. Three-dimensional gait data were captured in an intervention group of 19 patients with symptomatic medial knee osteoarthritis wearing their prescribed laterally wedged foot orthoses at 0 and 12 months. Wedge amounts were prescribed based on symptom response to a step-down test. A control group of 19 patients wearing prescribed neutral orthoses were also captured at 0 and 12 months. The gait of the intervention group wearing neutral orthoses was additionally captured. Walking speed and shoes were controlled. Analyses of variance were conducted to examine for group-by-time (between the groups in their prescribed orthoses) and condition-by-time (within the intervention group) interactions, main effects, and simple effects. We observed increased knee adduction moments and frontal plane motion over time in the control group but not the intervention group. Further, within the intervention group, the mechanical effectiveness of the lateral wedging did not decrease. In patients with medial knee osteoarthritis, the effects of lateral foot wedging on pathomechanics associated with medial knee osteoarthritis were favorable and sustained over time. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 659–664, 2013

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