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Lateral wedging for medial knee Osteoarthritis

June 16 2020

As a knee becomes more ‘bowed’ it is likely that medial (inside) knee osteoarthritis is developing. As the knee becomes more progressively bowed, the load increases on the inside knee compartment and reduces on the outside knee compartment. This increase load over time can lead to joint space narrowing and ‘bone on bone’ of the inside knee compartment.

During walking as the bowed knee is in the stance phase and the other leg is swinging forwards, the bowed knee or ‘varus’ knee can begin to give outwards  - we call this a varus thrust. This occurs as the ligaments on the outside of the knee are stretched and therefore not able to do provide adequate support to the knee.

Bowed or varus knees are more common in males and often end up needing a total knee replacement. If the patient is too young for a knee replacement and this knee joint is still in reasonable condition, a surgeon may opt to do a high tibial osteotomy surgery where they cut a triangle wedge out of the tibia to straighten the leg and therefore even out the load across the medial and lateral knee compartments. This surgery can be very effective but requires lots of down time and rehabilitation.

Lateral wedging is a conservative treatment option which aims to reduce the medial loading and therefore reduce the physical stress applied to the inside knee compartment. The wedge is placed inside footwear and is thicker on the lateral (outside) edge than the medial (inside) edge, helping to transfer load during weight-bearing from the medial to the lateral knee compartment. As a consequence of this medial knee unloading knee pain is often reduced.

Our Townsville Podiatrists can make lateral wedging in our in-house lab. Depending on your foot mechanics and arch stability – the wedge is either stand-alone or combined with a foot orthotic.

Lateral wedge insoles for medial knee osteoarthritis: Effects on lower limb frontal plane biomechanics




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