The Effect of Shoe Design and Lateral Wedging on Knee Loading

INTRODUCTION The mechanical environment of the knee during walking can influence both the health and breakdown of the knee cartilage. With walking being the most common activity of daily living as well as producing a cyclically reproducible pattern of loading a close link to the maintenance of healthy knee cartilage is indicated.(1) Normally 60–80% of the total intrinsic compressive load transmitted across the knee is on the medial compartment (7). Alignment of the knee influences the load distribution. In a varus knee (bow legged), the load-bearing axis is shifted so that the medial compartment experiences greater stress. In a valgus knee (knock-knee), stress is increased in the lateral compartment. The medial compartment is usually first affected by knee osteoarthritis (4). Foot wedges have shown promising results with potential pain reduction and knee load. There is a lack of high quality evidence to substantiate the effect of lateral wedges(2-4). Thus the aim of the present study is to evaluate the interaction between design of foot wear and the effect of lateral wedges and to investigate if their effectiveness correlates to a subject’s peak adduction moment prior to intervention.