title: American Society of Biomechanics Clinical Biomechanics Award 2013: tibiofemoral contact location changes associated with lateral heel wedging--a weight bearing MRI study.
abstract: BACKGROUND
  Vertically open magnetic resonance imaging permits study of knee joint contact during weight bearing. Lateral wedging is a low cost intervention for knee osteoarthritis that may influence load distribution and contact. This study assessed the ability of feedback-assisted weight bearing magnetic resonance imaging to detect changes in tibiofemoral contact associated with lateral wedging.
  
  
  METHODS
  One knee in each of fourteen subjects with symptomatic knee osteoarthritis was studied, without specification of compartmental involvement. Knees were imaged during upright standing and at 20° knee flexion. Bilateral external heel wedges were used to provide non-wedged and 5° lateral wedging conditions. Computer modeling was used to measure the medial and lateral compartment contact patch center coordinates on the tibial plateau and the respective contact areas.
  
  
  RESULTS
  Lateral heel wedging in flexion was associated with a significant anterior shift of the contact patch of the lateral femoral condyle. Changes with knee flexion were similar to previous reports: both medial and lateral contact centers moved posteriorly with flexion, and lateral condyle contact also moved laterally. Lateral condyle contact area significantly reduced with flexion, while lateral wedging did not significantly affect contact areas.
  
  
  CONCLUSIONS
  In symptomatic knee osteoarthritis patients standing in knee flexion, weight bearing magnetic resonance imaging recorded an anterior shift of lateral condyle contact in response to lateral heel wedging. Future studies may investigate lateral wedging effects more specifically in candidates for this clinical intervention.
authors.affiliation: Kessler Foundation Research Center, West Orange, NJ, USA; Rutgers New Jersey Medical School, Newark, NJ, USA. Electronic address: pbarrance@kesslerfoundation.org.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barrance
authors.affiliation: Kessler Foundation Research Center, West Orange, NJ, USA.
authors.forename: Venkata
authors.initials: V
authors.lastname: Gade
authors.affiliation: Kessler Foundation Research Center, West Orange, NJ, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Allen
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA; Kessler Institute for Rehabilitation, West Orange, NJ, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Cole
mesh_terms: D000328:Adult; D000368:Aged; D001363:Awards and Prizes; D001696:Biomechanical Phenomena / Q000502:physiology; D003198:Computer Simulation; D005260:Female; D005269:Femur / Q000502:physiology; D061826:Foot Orthoses; D006365:Heel; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000534:rehabilitation; D016059:Range of Motion, Articular / Q000502:physiology; D012955:Societies, Medical; D013977:Tibia / Q000502:physiology; D014481:United States; D016474:Weight-Bearing / Q000502:physiology*
keywords: Cartilage; Contact; Imaging; Knee; Lateral wedge; Osteoarthritis