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Wedged Insoles and Gait in Patients with Knee Osteoarthritis: A Biomechanical Review

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Abstract

The study of gait biomechanics in individuals with knee osteoarthritis has become widespread, especially in regards to the knee adduction moment—a variable commonly believed to be associated with knee osteoarthritis progression. Unfortunately, this variable is often studied clinically without considering how it is derived, or what it means in a mechanical context. The use of footwear for knee osteoarthritis management has received much attention as well. However, in many cases, footwear is studied without regard for the mechanical effects they actually induce on the patient. Therefore, this review aims to summarize the current state of knowledge in regards to knee osteoarthritis gait and footwear biomechanics, by taking a step back to review the foundations of these two research areas. First, an overview of the calculation of the knee adduction moment is provided, along with mechanical considerations. Then, this is used to discuss current evidence for wedged insoles and highlight knowledge gaps. The intent was to place this mechanical information in a clinically-oriented framework for approachability by scientists, engineers and clinicians alike. Based on this discussion, areas for future investigation are proposed.

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Funding

RTL is funded by an Alberta Innovates-Health Solutions MD-PhD Studentship. Funding agencies played no role in the development of this article.

Conflict of interest

RTL and DJS have filed a US Provisional Patent 62/183,055.

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Authors and Affiliations

  1. Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada

    Ryan T. Lewinson & Darren J. Stefanyshyn

  2. Schulich School of Engineering, University of Calgary, Calgary, AB, Canada

    Ryan T. Lewinson & Darren J. Stefanyshyn

  3. Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada

    Ryan T. Lewinson

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Correspondence to Ryan T. Lewinson.

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Lewinson, R.T., Stefanyshyn, D.J. Wedged Insoles and Gait in Patients with Knee Osteoarthritis: A Biomechanical Review. Ann Biomed Eng 44, 3173–3185 (2016). https://doi.org/10.1007/s10439-016-1696-1

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