Article

Laterally wedged insoles are widely applied in the conservative
treatment for medial knee osteoarthritis. Experimental studies have been
conducted to understand the effectiveness of such an orthotic intervention.
However, the information was limited to the joint external loading such as knee
adduction moment. The internal stress distribution is difficult to be obtained
from in vivo experiment alone. Thus, a three-dimensional finite element model of
the human knee-ankle-foot complex, together with orthosis, was developed in this
study and used to investigate the redistribution of knee stress using laterally
wedged insole intervention. METHODS: Laterally wedged insoles with wedge angles
of 0, 5, and 10 degrees were fabricated for intervention. The subject-specific
geometry of the lower extremity with details was characterized in the
reconstruction of MR images. Motion analysis data and muscle forces were input to
drive the model. The established finite element model was employed to investigate
the loading responses of tibiofemoral articulation in three wedge angle
conditions during simulated walking stance phase. FINDINGS: With either of the 5
degrees or 10 degrees laterally wedged insole, significant decreases in von Mises
stress and contact force at the medial femur cartilage region and the medial
meniscus were predicted comparing with the 0 degrees insole. INTERPRETATION: The
diminished stress and contact force at the medial compartment of the knee joint
demonstrate the immediate effect of the laterally wedged insoles. The
intervention may contribute to medial knee osteoarthritis rehabilitation.
CI - Copyright (c) 2012 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS