Inconsistent knee varus moment reduction caused by a lateral wedge in knee osteoarthritis

  • Kakihana W
  • Akai M
  • Nakazawa K
 et al. 
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OBJECTIVE: To determine--with the assistance of a larger sample size--whether the inconsistency of reducing the knee-joint varus moment with a lateral wedge in patients with medial compartment knee osteoarthritis (OA) persists and if so, what underlying mechanisms may explain it. DESIGN: Crossover design whereby 51 patients with bilateral isolated medial compartment knee OA and 19 age-matched healthy controls walked with two different wedge conditions: a 0-degree control wedge and a 6-degree lateral wedge. We conducted three-dimensional motion analysis, hip-knee-ankle (HKA) angle measurement, and radiologic assessment with Kellgren-Lawrence grade. We investigated frontal plane angles and moments at the knee and subtalar joints, ground reaction forces, and center of pressure (CoP). Moments were derived using a three-dimensional inverse dynamics model of the lower extremity. RESULTS: Nine patients (17.6%) had an increased knee-joint varus moment with the 6-degree lateral wedge via the medially shifted location of the CoP. These patients did not differ from the remaining patients in HKA angle and radiologic assessment. CONCLUSION: 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.

Author-supplied keywords

  • Biomechanics
  • Osteoarthritis
  • Rehabilitation
  • Shoes

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  • Wataru Kakihana

  • Masami Akai

  • Kimitaka Nakazawa

  • Kenji Naito

  • Suguru Torii

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