Lewinson Ryan T, Stefanyshyn Darren J
Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Schulich School of Engineering, University of Calgary, Calgary, AB, Canada.
Ann Biomed Eng. 2016 Nov;44(11):3173-3185. doi: 10.1007/s10439-016-1696-1. Epub 2016 Jul 19.
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.
对膝骨关节炎患者的步态生物力学研究已广泛开展，尤其是关于膝关节内收力矩——一种普遍认为与膝骨关节炎进展相关的变量。不幸的是，临床上对该变量的研究往往不考虑其如何得出，或在力学背景下意味着什么。使用鞋类来管理膝骨关节炎也受到了很多关注。然而，在许多情况下，对鞋类的研究并未考虑它们实际对患者产生的力学影响。因此，本综述旨在通过回顾这两个研究领域的基础，总结关于膝骨关节炎步态和鞋类生物力学的当前知识状态。首先，提供膝关节内收力矩计算的概述以及力学考量。然后，以此来讨论楔形鞋垫的现有证据并突出知识空白。目的是将这些力学信息置于一个面向临床的框架中，以便科学家、工程师和临床医生都能理解。基于此讨论，提出了未来的研究方向。
