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Studies of lateral wedge insoles (LWIs) in medial knee osteoarthritis (OA) have shown reductions in the average external knee adduction moment (EKAM) but no lessening of knee pain. Some treated patients actually experience increases in the EKAM which could explain the overall absence of pain response. We examined whether, in patients with painful medial OA, reductions in the EKAM were associated with lessening of knee pain. Each patient underwent gait analysis whilst walking in a control shoe and two LWI's. We evaluated the relationship between change in EKAM and change in knee pain using Spearman Rank Correlation coefficients and tested whether dichotomizing patients into biomechanical responders (decreased EKAM) and non-responders (increased EKAM) would identify those with reductions in knee pain. In 70 patients studied, the EKAM was reduced in both LWIs versus control shoe (-5.21% and -6.29% for typical and supported wedges, respectively). The change in EKAM using LWIs was not significantly associated with the direction of knee pain change. Further, 54% were biomechanical responders, but these persons did not have more knee pain reduction than non-responders. Whilst LWIs reduce EKAM, there is no clearcut relationship between change in medial load when wearing LWIs and corresponding change in knee pain.

Original publication

DOI

10.1002/jor.22666

Type

Journal article

Journal

J orthop res

Publication Date

09/2014

Volume

32

Pages

1147 - 1154

Keywords

adduction moment, knee, lateral wedge, osteoarthritis, pain, Aged, Arthralgia, Biomechanical Phenomena, Female, Foot Orthoses, Gait, Humans, Knee Joint, Male, Middle Aged, Osteoarthritis, Knee, Prevalence, Range of Motion, Articular, Treatment Failure, Treatment Outcome, Weight-Bearing