Osteoarthritis (OA) can occur in any joint but is most common in the knee. The load placed on the knee determines how quickly the disease progresses. A 20 percent increase in the load on the knee is associated with increasing the risk of progression of osteoarthritis by 600%. Two common recommendations for knee OA patients to reduce the load on the knee are proper shoes and use of a cane.

Researchers at the University of Melbourne, led by Dr. Rana S. Hinman, performed 3-dimensional (3D) gait analysis of 40 volunteers. The 16 men and 24 women all met the criteria for knee OA and had symptoms such as persistent knee pain and loss of physical function. The participants averaged 65 years of age and none had undergone a joint replacement.

The 3D analysis of each volunteer was performed on the most affected knee using a Vicon 6-camera motion analysis system. In addition, force plates were embedded in the walkway to measure ground impact and reflective markers were placed on the pelvis, thigh, knee joint and foot to record limb movement.

Each participant was tested in bare feet, followed by testing in their own shoes. Further, 20 of the volunteers were tested in their own walking shoes and using a cane in the hand opposite of the knee being measured. They were given instruction in ideal cane use by a trained physiotherapist.

5 trials were conducted to calculate changes in gait parameters and the load on the knee.

Most of the participants experienced increased load on the knee (more than 7% higher) while wearing shoes over walking barefoot. Using a cane reduced the load by an average 10%, a benefit the researchers considered to be significant. A quarter of the volunteers experienced a load reduction of over 20%.

“Further studies are required to establish whether knee loading remains lower with ongoing use of a cane,” notes Dr. Hinman, “and whether the reductions in loading translate to a reduced risk of disease progression.”