Application of a Lateral Heel Wedge as a Nonsurgical Treatment for Varum Gonarthrosis

Abstract

Although anecdotal evidence supports the application of a lateral heel wedge (LHW) as a nonoperative treatment for varum gonarthrosis, objective evaluation of its mechanism of action is limited. Roentgenograms, ground reaction forces and electromyographical (EMG) profiles were incorporated to study the effect of LHW on the medial osteoarthritic knee of seven males during static and dynamic conditions. Results indicated both static and dynamic changes associated with the application of a LHW. Roentgenograms indicated a varum to valgum directional change (p<.05) in the capito-midcondylar-tibial shaft angle during static standing. There was minimal impact on the mean vertical forces while there were increases in the maximum lateral forces (p<.05) during walking with the LHW treatment. No statistical differences were observed for the EMG profiles between conditions. These results provide some insight into the functional effects of the LHW on the kinetics of the lower leg during static standing and free-speed gait. © 1995 American Academy of Orthotists & Prosthetists