Effective Gait Modification Strategies for Offloading the Medial Compartment of the Knee

Gait modification is a conservative, non-invasive treatment option for patients with medial compartment knee osteoarthritis. If proven effective for offloading the medial compartment, it may provide one of the few treatment options with disease modifying potential. Furthermore, it could fill an important therapeutic “hole” for patients in their 40’s and 50’s who no longer achieve sufficient pain relief through pharmacological means and yet are too young to receive a total knee replacement. A variety of gait modifications have been proposed for offloading the medial compartment, including toeing out [1], walking more slowly or with decreased stride length [2], walking with increased medial-lateral trunk sway [3], using lateral heel wedges [4], or walking with medialized knees [5]. These modifications have been proposed primarily based on their ability to reduce the external knee adduction torque. While this external measure is highly correlated with medial compartment contact force [6], the acid test is to demonstrate experimentally that a gait modification reduces medial contact force directly.