Inconsistent Knee Varus Moment Reduction Caused by a Lateral Wedge in Knee Osteoarthritis

Abstract

In approximately 18% of patients with bilateral medial compartment knee OA, the 6-degree lateral wedge seems to fail to reduce the knee-joint varus moment. The indication and limitations of lateral wedge should be confirmed by a randomized controlled study.

Kinematic adaptations to a variable stiffness shoe: Mechanisms for reducing joint loading

“…The variable stiffness shoe results are in contrast to studies with laterally wedged insoles that in both healthy and subjects with OA have had mixed results (Baker et al, 2007;Bennell et al, 2011;Fang et al, 2006;Kakihana et al, 2007;Kutzner et al, 2011;Toda and Tsukimura, 2004). The mechanism by which the external adduction moment is reduced in the VS shoe is not clear.…”

“…A comparison of the dynamic changes associated with the variable stiffness shoe to kinematic changes in fixed interventions such as lateral wedge shoes might help to explain the difference in the clinical outcome (Erhart et al, 2010) with this shoe relative to the inconsistent results seen with wedged interventions (Kakihana et al, 2007;Toda and Tsukimura, 2004). The primary difference between response to lateral wedge interventions and the variable stiffness shoe is the direction of shift in the COP in combination with the change in the m-l GRF (Fantini Pagani et al, 2011;Kakihana et al, 2007). A lateral shift in the COP and in some instances an increase in the m-l GRF has been reported for the lateral wedge interventions (Fantini Pagani et al, 2011;Hinman et al, 2012;Kakihana et al, 2007).…”

“…The primary difference between response to lateral wedge interventions and the variable stiffness shoe is the direction of shift in the COP in combination with the change in the m-l GRF (Fantini Pagani et al, 2011;Kakihana et al, 2007). A lateral shift in the COP and in some instances an increase in the m-l GRF has been reported for the lateral wedge interventions (Fantini Pagani et al, 2011;Hinman et al, 2012;Kakihana et al, 2007). The kinematic changes that were associated with these changes in the reaction forces are a slight increase in the abduction angle and greater ankle eversion.…”

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

“…12,[18][19][20] In contrast, no reduction of peak EAMs was found by Schmalz et al 21 when walking with wedged shoes without ankle support. In a study from Kakihana et al, 22 increased EAMs were even reported in about 18% of the patients analyzed.…”

Prospective study on the effects of orthotic treatment for medial knee osteoarthritis in Chinese patients: clinical outcome and gait analysis

“…Biomechanical studies have demonstrated a small effect size in reduction of KAM with a valgus knee brace [7][8][9][10] and lateral-wedged insoles. [11][12][13][14] This study is the first to sequentially evaluate the clinical outcomes and gait analyses of different orthotic treatments in Chinese patients with medial compartment osteoarthritis.…”