Effects of disease severity on response to lateral wedged shoe insole for medial compartment knee osteoarthritis

Objective: To determine the effects of lateral wedged in soles on knee kinetics and kinematics during walking, according to radiographic severity of medial compartment knee osteoarthritis (OA). Design: A prospective case control study of patients with medial compartment OA of the knee. Setting: Gait analysis laboratory in a university hospital. Participants: Forty-six medial compartment knees with OA of 23 patients with bilateral disease and 38 knees of 19 age-matched healthy subjects as controls. Interventions: Not applicable. Main Outcome Measures: We measured the peak external adduction moment at the knee during the stance phase of gait and the first acceleration peak after heel strike at the lateral side of the femoral condyles. Kellgren and Lawrence grading system was used for radiographic assessment of OA severity. Results: The mean value of peak external adduction moment of the knee was higher in OA knees than the control. Application of lateral wedged insoles significantly reduced the peak external adduction moment in Kellgren-Lawrence grades I and It knee OA patients. The first acceleration peak value after heel strike in these patients was relatively high compared with the control. Application of lateral wedged insoles significantly reduced the first acceleration peak in Kellgren-Lawrence grades I and II knee OA patients. Conclusions: The kinetic and kinematic effects of wearing of lateral wedged insoles were significant in Kellgren-Lawrence grades I and II knee OA. The results support the recommendation of use of lateral wedged insoles for patients with early and mild knee OA.