Effect of lateral wedged insoles on the knee internal contact forces in medial knee osteoarthritis
File version
Author(s)
Dell'Isola, A
Andersen, MS
Woodburn, J
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
License
Abstract
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.
Journal Title
Gait & Posture
Conference Title
Book Title
Edition
Volume
68
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject
Mechanical engineering
Clinical sciences
Sports science and exercise
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Orthopedics
Sport Sciences
Persistent link to this record
Citation
Mannisi, M; Dell'Isola, A; Andersen, MS; Woodburn, J, Effect of lateral wedged insoles on the knee internal contact forces in medial knee osteoarthritis, Gait & Posture, 2019, 68, pp. 443-448