Effect of lateral wedged insoles on the knee internal contact forces in medial knee osteoarthritis.
Contact force
Gait
Knee
Musculoskeletal modelling
Osteoarthritis
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
20
04
2018
revised:
19
10
2018
accepted:
21
12
2018
pubmed:
31
12
2018
medline:
24
4
2019
entrez:
31
12
2018
Statut:
ppublish
Résumé
Lateral wedge insoles (LWIs) are non-surgical interventions used in medial knee osteoarthritis (KOA) aiming at restoring correct joint biomechanics. However, the mechanical efficacy of LWIs, based on modulation of the external knee adduction moment, is partially proved and high variability in response to these devices was observed. The principal aim of the study was to employ subject-specific musculoskeletal models to investigate the immediate effect of LWIs on the medial compressive force (MCF) in a population with medial KOA and varus alignment. Fifteen adults (8 healthy controls age 56±3.4, BMI 25.2±2.2, hip-knee-ankle angle -1.3±2.3; and 7 KOA participants age 62±6.6, BMI 31.7±3.9, hip-knee-ankle angle 6.3±2) were recruited. Subject-specific LWIs were designed in CAD based on shape capture of the foot and manufactured via 3D printing. The required degree of heel post was added to the orthotic shell to create insoles with 0°, 5° and 10° of lateral wedge. Gait data were collected for each condition and a musculoskeletal model implemented in the Anybody Modeling System estimated the CFs normalised per bodyweight. The effect of the LWIs with respect to the baseline on the peak and the impulse of the MCF were tested with a Wilcoxon non-parametric test for paired samples. For the KOA group, LWIs did not reduce significantly the impulse and the peak of the MCF. No dose-response trend according to the degree of wedging was observed. A high inter-subject variability was found: the impulse of the MCF varied between -12%, +10%, the peak between -5%, +7%. Moreover, LWIs had no consistent effect on shifting the load from the medial to the lateral compartment. Subject-specific response to LWIs in a cohort of medial KOA patients was observed. Further studies are necessary to maximise the mechanical effect of LWIs on restoring normal knee joint mechanics.
Sections du résumé
BACKGROUND
Lateral wedge insoles (LWIs) are non-surgical interventions used in medial knee osteoarthritis (KOA) aiming at restoring correct joint biomechanics. However, the mechanical efficacy of LWIs, based on modulation of the external knee adduction moment, is partially proved and high variability in response to these devices was observed.
RESEARCH QUESTION
The principal aim of the study was to employ subject-specific musculoskeletal models to investigate the immediate effect of LWIs on the medial compressive force (MCF) in a population with medial KOA and varus alignment.
METHODS
Fifteen adults (8 healthy controls age 56±3.4, BMI 25.2±2.2, hip-knee-ankle angle -1.3±2.3; and 7 KOA participants age 62±6.6, BMI 31.7±3.9, hip-knee-ankle angle 6.3±2) were recruited. Subject-specific LWIs were designed in CAD based on shape capture of the foot and manufactured via 3D printing. The required degree of heel post was added to the orthotic shell to create insoles with 0°, 5° and 10° of lateral wedge. Gait data were collected for each condition and a musculoskeletal model implemented in the Anybody Modeling System estimated the CFs normalised per bodyweight. The effect of the LWIs with respect to the baseline on the peak and the impulse of the MCF were tested with a Wilcoxon non-parametric test for paired samples.
RESULTS
For the KOA group, LWIs did not reduce significantly the impulse and the peak of the MCF. No dose-response trend according to the degree of wedging was observed. A high inter-subject variability was found: the impulse of the MCF varied between -12%, +10%, the peak between -5%, +7%. Moreover, LWIs had no consistent effect on shifting the load from the medial to the lateral compartment.
SIGNIFICANCE
Subject-specific response to LWIs in a cohort of medial KOA patients was observed. Further studies are necessary to maximise the mechanical effect of LWIs on restoring normal knee joint mechanics.
Identifiants
pubmed: 30594873
pii: S0966-6362(18)30371-0
doi: 10.1016/j.gaitpost.2018.12.030
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
443-448Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.