Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles? : an ancillary analysis from the SILK trial

Chapman, GJ; Parkes, MJ; Forsythe, L; Felson, DT; Jones, RK

Abstract

Objective: Lateral wedge insoles are a potential simple treatment for medial knee osteoarthritis (OA)
patients by reducing the external knee adduction moment (EKAM). However in some patients, an increase
in their EKAM is seen. Understanding the role of the ankle joint complex in the response to lateral
wedge insoles is critical in understanding and potentially identifying why some patients respond
differently to lateral wedge insoles.
Method: Participants with medial tibiofemoral OA underwent gait analysis whilst walking in a control
shoe and a lateral wedge insole. We evaluated if dynamic ankle joint complex coronal plane biomechanical
measures could explain and identify those participants that increased (biomechanical nonresponder)
or decreased (biomechanical responder) EKAM under lateral wedge conditions compared
to the control shoe.
Results: Of the 70 participants studied (43 male), 33% increased their EKAM and 67% decreased their
EKAM. Overall, lateral wedge insoles shifted the centre of foot pressure laterally, increased eversion of
the ankle/subtalar joint complex (STJ) and the eversion moment compared to the control condition.
Ankle angle at peak EKAM and peak eversion ankle/STJ complex angle in the control condition predicted
if individuals were likely to decrease EKAM under lateral wedge conditions.
Conclusions: Coronal plane ankle/STJ complex biomechanical measures play a key role in reducing EKAM
when wearing lateral wedge insoles. These findings may assist in the identification of those individuals
that could benefit more from wearing lateral wedge insoles.

Citation

Chapman, G., Parkes, M., Forsythe, L., Felson, D., & Jones, R. (2015). Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles? : an ancillary analysis from the SILK trial. Osteoarthritis and Cartilage, 23(8), 1316-1322. https://doi.org/10.1016/j.joca.2015.02.164

• Journal Article Type: Article
• Acceptance Date: Feb 23, 2015
• Online Publication Date: Mar 5, 2015
• Publication Date: Aug 1, 2015
• Deposit Date: Jun 11, 2015
• Publicly Available Date: May 26, 2017
• Journal: Osteoarthritis and Cartilage
• Print ISSN: 1063-4584
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 8
• Pages: 1316-1322
• DOI: https://doi.org/10.1016/j.joca.2015.02.164
• Publisher URL: http://dx.doi.org/10.1016/j.joca.2015.02.164
• Related Public URLs: http://www.sciencedirect.com/science/journal/10634584