Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
J Biomech. 2013 Feb 22;46(4):796-800. doi: 10.1016/j.jbiomech.2012.11.020. Epub 2012 Dec 6.
Since footwear is commonly used every day, its influence on knee joint loading and thereby on the development and progression of osteoarthritis may be crucial. So far the influence of footwear has been examined only indirectly. The aim of this study was to directly measure the effect of footwear on tibiofemoral contact loads during walking. Instrumented knee implants with telemetric data transmission were used to measure the tibiofemoral contact forces and moments in six subjects. The loads during walking with four different shoes (basic running shoes, advanced running shoes, classical dress shoes and shoes with a soft rounded sole in the sagittal plane (MBT)) were compared to those during barefoot walking. Peak values of all six load components were analyzed. In general, footwear tended to increase knee joint loading slightly, with the dress shoe being the most unfavorable type of footwear. At the early stance phase all load components were increased by all shoe types. The resultant force rose by 2-5%, the internal adduction moment by 7-12% and the forces on the medial compartment by 3-5%. Significant reductions of the resultant force were solely observed for the advanced running shoe (-6%) and the MBT (-9%) shoe at late stance. Also the medial compartment force was slightly yet non-significantly reduced by 2-5% with the two shoes. It is questionable whether such small load changes have an influence on the progression of gonarthrosis. Future research is necessary to examine which factors regarding the shoe design, such as heel height, arch support or flexibility are most decisive for a reduction of knee joint loading.
由于每天都普遍穿着鞋子，它对膝关节负荷的影响，以及对骨关节炎的发展和进展的影响可能是至关重要的。到目前为止，人们只是间接地研究了鞋子的影响。本研究的目的是直接测量鞋子对步行时胫骨股骨接触负荷的影响。使用带有遥测数据传输的仪器化膝关节植入物来测量 6 名受试者的胫骨股骨接触力和力矩。将穿四种不同鞋子（基本跑鞋、高级跑鞋、经典礼服鞋和在矢状面具有柔软圆形鞋底的鞋子（MBT））时的负荷与赤脚行走时的负荷进行比较。分析了所有六个负荷分量的峰值。一般来说，鞋子会略微增加膝关节的负荷，而礼服鞋是最不利的鞋子类型。在早期站立阶段，所有鞋子类型都会增加所有的负荷分量。合力增加 2-5%，内收力矩增加 7-12%，内侧间室的力增加 3-5%。仅在晚期站立时，高级跑鞋（-6%）和 MBT（-9%）鞋会显著降低合力。两种鞋子也会使内侧间室力略有但无统计学意义地降低 2-5%。如此小的负荷变化是否会对关节炎的进展产生影响还值得怀疑。未来的研究有必要检查鞋子设计的哪些因素，如鞋跟高度、足弓支撑或柔韧性，对减少膝关节负荷最具决定性。
