Contralateral & ipsilateral cane usage by patients with osteoarthritic knee

Abstract

Knee osteoarthritis is frequently associated with pain and deformity. A walking cane is prescribed to reduce loading across the affected joint. The cane placement is important in order to minimize joint loading and slow the progression of the osteoarthritis. The aim of the study was to compare the joint unloading effect of ipsilateral and contralateral cane use of patients with osteoarthritic knee during walking. The gait of fourteen subjects with osteoarthritic knee was studied under three walking conditions. They were (a) walking unaided, (b) walking with a cane held on the ipsilateral (same) side, and (c) walking with a cane held on the contralateral (opposite) side to the affected knee. The kinematics and force data of each walking condition were measured by a VICON 370 motion analysis system and force platforms respectively. These data were then combined with the anthropometric measures to calculate the knee joint moments by the process of inverse dynamics. Values were then obtained for the sagittal and frontal plane knee moments, frontal plane hip moment, temporal-spatial variables and axial force of the instrumented cane. The hip abduction moment was used a crosscheck for the validity of the data. Differences between the three walking conditions were identified using the repeated measures ANOVA. Contralateral cane use gave rise to the lowest knee abductor and knee flexor moments of force in both knee deformity (varus / valgus) conditions. From the results of this study, it can be seen that a cane may play a beneficial role in persons with knee osteoarthritis by placing it on the contralateral side of the affected extremity.