title: The lateral wedged insole with subtalar strapping significantly reduces dynamic knee load in the medial compartment gait analysis on patients with medial knee osteoarthritis.
abstract: OBJECTIVE
  Two lateral wedged insoles were compared: one with, and the other without, subtalar strapping.
  
  
  METHODS
  Twenty-one patients (age 58-83, mean 72) with medial knee osteoarthritis (OA) were enrolled. Thirty-seven knees in the patients were divided into three groups based on the Kellgren and Lawrence OA grading system; grades 2 (cases=20), 3 (cases=11), and 4 (cases=6). The subjects were tested during walking barefoot and during walking with a silicon rubber lateral wedged insole with elevation of 10 mm attached to a barefoot. Gait analysis was performed on a 10 m walkway for each subject under three different walking conditions; barefoot, wearing a conventional insole, and a subtalar strapping insole. Peak knee varus moment during gait was measured under each condition, and compared between the three conditions and between the OA grades.
  
  
  RESULTS
  On the whole (cases=37), the peak varus moment was significantly reduced by wearing either of the insoles, compared to walking barefoot. The reduction was more obvious with the strapping insole (-13%, P<0.01), compared with the conventional insole (-8%, P<0.05). In moderate OA patients (grades 2 and 3), the moments were significantly lower with the strapping insole, compared with the conventional insole (P=0.0048 and 0.005, respectively). However, no significant difference was detected in severe OA patients (grade 4) between the two types of insoles (P=0.4).
  
  
  CONCLUSIONS
  Both lateral wedged insoles significantly reduced the peak medial compartment load during gait. The subtalar strapping insole had a greater effect than the conventional insole, particularly in patients with moderate medial knee OA.
authors: Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan. yuji-kuro@nifty.com
authors: Y
authors: Y
authors: Kuroyanagi
authors: T
authors: T
authors: Nagura
authors: H
authors: H
authors: Matsumoto
authors: T
authors: T
authors: Otani
authors: Y
authors: Y
authors: Suda
authors: T
authors: T
authors: Nakamura
authors: Y
authors: Y
authors: Toyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008875:Middle Aged; D009989:Orthotic Devices; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000534:rehabilitation / Q000628:therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012775:Shoes; D013628:Talus; D016138:Walking; D016474:Weight-Bearing