Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Knee. 2021 Jan;28:110-116. doi: 10.1016/j.knee.2020.11.016. Epub 2020 Dec 14.
Medial meniscus extrusion (MME) leads to symptomatic knee osteoarthritis (OA) due to increased mechanical stress. MME increases with weight-bearing, and the difference in MME between non-weight-bearing and weight-bearing status (ΔMME) is a factor that causes greater MME. The lateral wedge insole (LWI) is an ideal approach for decreasing the amount of ΔMME associated with the reduction of medial loading stress in the early stage of knee OA. However, the effect of the LWI for 3 months on the ΔMME and its response to OA stage have not been elucidated.
To investigate the effects of the LWI for 3 months on MME and the ΔMME in each stage of OA.
Participants were divided into three groups: no intervention with the LWI (control group; n = 9) and intervention with the LWI in early OA (early OA group: Kellgren-Lawrence (K/L) stage = 2, n = 17) and late OA (late OA group: K/L stage > 2, n = 13). MME was evaluated using ultrasound, and the ΔMME was obtained as the difference in MME from non-weight-bearing and weight-bearing conditions. These measurements were performed at two time points: the initial office visit as a baseline and post-3 months.
The weight-bearing MME and ΔMME values post-3 months were significantly decreased compared with those at baseline in the early OA group but not in the control or late OA groups.
The use of the LWI for 3 months decreased weight-bearing MME and ΔMME values, and its effectiveness was more pronounced in the early stage of knee OA.
内侧半月板挤压（MME）会导致膝关节骨性关节炎（OA）的症状，这是由于机械应力增加所致。MME 随负重而增加，非负重与负重状态之间的 MME 差异（ΔMME）是导致 MME 增加的一个因素。外侧楔形鞋垫（LWI）是一种理想的方法，可以通过降低内侧负荷应力来减少膝关节 OA 早期与 ΔMME 相关的量，从而减少内侧负荷应力。然而，LWI 在 3 个月内对 ΔMME 的影响及其对 OA 分期的反应尚未阐明。
研究 LWI 在 3 个月内对 OA 各期 MME 和 ΔMME 的影响。
参与者分为三组：不使用 LWI 的无干预组（对照组；n=9）和使用 LWI 的早期 OA 组（早期 OA 组：Kellgren-Lawrence（K/L）分期=2，n=17）和晚期 OA 组（晚期 OA 组：K/L 分期>2，n=13）。使用超声评估 MME，并通过非负重和负重状态之间的 MME 差异获得 ΔMME。这些测量在两个时间点进行：初始就诊时作为基线和 3 个月后。
与基线相比，早期 OA 组在 3 个月后负重 MME 和 ΔMME 值显著降低，但对照组和晚期 OA 组无显著降低。
使用 LWI 3 个月可降低负重 MME 和 ΔMME 值，在膝关节 OA 的早期阶段效果更为明显。
