Effectiveness of different orthoses on joint moments in patients with early knee osteoarthritis: Lateral wedge versus valgus knee bracing

The purpose of the study was to test the biomechanical differences between a lateral wedge and a valgus knee bracing on the knee joint moment during walking in patients with early stage of medial compartment knee osteoarthritis (OA). We conducted a crossover randomized design to compare gait parameters of 32 patients (with early stage medial compartment knee OA) in three different conditions during walking: with a custom-made lateral wedge of 5° (in standard shoes), with a valgus knee bracing (in standard shoes), and with control condition (in standard shoes). Both two-orthose conditions showed decreased loading patterns (knee adduction moment and knee adduction angular impulse) on the knee joint in dynamic condition (statistic probability P < 0.05). The decreased loading on OA knee in wedge condition was associated with a laterally shifted location of centre of pressure and increased ankle valgus degree and moment at the same foot (P < 0.05). It was not found significant differences in loading of the knee between these two-orthose conditions. These results indicated that, under dynamic condition, patients wearing lateral wedge and valgus knee bracing showed changes of moments on knee joints. Lateral wedge was as effective as valgus knee bracing in the treatment of early stage of knee OA.     

城市道路自行车“行路难”问题探析

在我国交通资源严重不足的情况下,自行车道却被迫“隐退”和“压缩”。表面上看这是个交通问题,实际上却是一个城市管理者是否以人为本,是否尊重公民权利（行路权）的问题。要解决城市道路自行车“行路难”问题,是一个综合性的社会问题,不仅仅在于宣传和呼吁,也应该健全法律法规,完善软硬件配套设施。