Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
Kintec Footlabs Inc, Surrey, BC, Canada.
J Appl Biomech. 2024 Jun 4;40(4):270-277. doi: 10.1123/jab.2023-0168. Print 2024 Aug 1.
Imbalanced joint load distribution across the tibiofemoral surface is a risk factor for osteoarthritic changes to this joint. Lateral wedge insoles, with and without arch support, are a form of biomechanical intervention that can redistribute tibiofemoral joint load, as estimated by external measures of knee load. The objective of this study was to examine the effect of these insoles on the internal joint contact characteristics of osteoarthritic knees during weightbearing. Fifteen adults with tibiofemoral osteoarthritis underwent magnetic resonance imaging of the affected knee, while standing under 3 insole conditions: flat control, lateral wedge alone, and lateral wedge with arch support. Images were processed, and the surface area and centroid location of joint contact were quantified separately for the medial and lateral tibiofemoral compartments. Medial contact surface area was increased with the 2 lateral wedge conditions compared with the control (P ≤ .012). A more anterior contact centroid was observed in the medial compartment in the lateral wedge with arch support compared with the lateral wedge alone (P = .009). Significant changes in lateral compartment joint contact outcomes were not observed. These findings represent early insights into how loading at the tibiofemoral interface may be altered by lateral wedge insoles as a potential intervention for knee osteoarthritis.
髌股关节表面的关节负荷分布不平衡是导致该关节发生骨关节炎变化的一个危险因素。外侧楔形鞋垫，有和没有足弓支撑，是一种生物力学干预形式，可以通过外部测量膝关节负荷来重新分配髌股关节负荷。本研究的目的是研究这些鞋垫在负重状态下对骨关节炎膝关节内部关节接触特征的影响。15 名髌股关节炎成年人在 3 种鞋垫条件下接受了受影响膝关节的磁共振成像检查：平垫、单独外侧楔形垫和外侧楔形垫加足弓支撑。对图像进行处理，并分别对内侧和外侧髌股关节腔的关节接触表面积和质心位置进行量化。与对照组相比，两种外侧楔形垫条件下的内侧接触表面积增加（P≤.012）。与单独外侧楔形垫相比，外侧楔形垫加足弓支撑时内侧关节腔的接触质心更靠前（P=.009）。未观察到外侧关节腔关节接触结果的显著变化。这些发现代表了早期的见解，即外侧楔形鞋垫作为治疗膝关节骨关节炎的潜在干预措施，可能会改变髌股关节界面的加载方式。
