Hi all, I am keen to start my research project on the effectiveness of lateral wedge (full length or heel wedge) to improve the pain in people with stage 1 and stage 2 medial knee osteoarthritis.
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The mechanical factor of genu varum is associated with a four-fold increase in the odds of medial knee osteoarthritis over an eighteen months follow-up(Chang et al., 2004). Knee osteoarthritis with genu varum deformity is characterised by ground reaction force vector generated at plantar aspect of foot pass medially to knee joint centre. The knee adduction moment (KAM) arm is increased as the knee is in varus position leading to an increase in magnitude of external knee adduction moment (EKAM) (see Figure 1) (Hinman & Bennell, 2009). A greater EKAM increases loading of knee joint believed to be associated with pain (Sasaki & Yasuda, 1987). The calcaneus is assumed perfectly aligned with the tibia and that the subtalar joint (STJ) axis is directly in the centre of these two segments, the ground reaction force will exert a slight STJ supination moment(van Gheluwe, Kirby, & Hagman, 2005). The laterally wedging insole shifts the centre of pressure laterally to realign the mechanic axis of ankle, knee and hip joints.
As we aware that there is a small number of people (approximate 15%) have perfectly aligned with tibia and STJ axis is directly in the center of these two segments.
My question are the clinical results of those "normal" patients of using lateral wedging. What are FPI of those patients with medial knee osteoarthritis?
Many thanks!
Carol
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