Effective gait patterns for offloading the medial compartment of the knee

Gait modification offers a noninvasive option for offloading the medial compartment of the knee in patients with knee osteoarthritis. While gait modifications have been proposed based on their ability to reduce the external knee adduction moment, no gait pattern has been proven to reduce medial compartment contact force directly. This study used in vivo contact force data collected from a single subject with a force-measuring knee replacement to evaluate the effectiveness of two gait patterns at achieving this goal. The first was a "medial thrust" gait pattern that involved medializing the knee during stance phase, while the second was a "walking pole" gait pattern that involved using bilateral walking poles commonly used for hiking. Compared to the subject's normal gait pattern, medial thrust gait produced a 16% reduction and walking pole gait a 27% reduction in medial contact force over stance phase, both of which were statistically significant based on a two-tailed Mann-Whitney U-test. While medial thrust gait produced little change in lateral and total contact force over the stance phase, walking pole gait produced significant 11% and 21% reductions, respectively. Medial thrust gait may allow patients with knee osteoarthritis to reduce medial contact force using a normal-looking walking motion requiring no external equipment, while walking pole gait may allow patients with knee osteoarthritis or a knee replacement to reduce medial, lateral, and total contact force in situations where the use of walking poles is possible.