Biomechanical Interventions for Knee Osteoarthritis Management

Knee osteoarthritis is characterised by pain, joint degeneration and altered loading patterns that accelerate cartilage breakdown. Biomechanical interventions aim to redistribute load away from degenerated compartments, improve alignment and enhance neuromuscular control. External supports such as unloader braces apply corrective moments in the frontal plane to reduce medial compartment forces. Footwear modifications and lateral wedge insoles alter centre-of-pressure trajectories to diminish knee adduction moments during gait. Custom foot orthoses and cushioned sport shoes seek to optimise foot alignment and attenuate impact. Gait retraining programmes use real-time feedback and wearable sensors to encourage joint-sparring movement patterns. Emerging wearable exoskeletons and soft actuators actively assist knee extension and flexion, reducing muscular demand and joint stress. Muscle–tendon unit training, targeting calf and quadriceps stiffness, can modulate load transmission through the limb. Together, these strategies provide conservative, non-pharmacological avenues to alleviate symptoms, improve function and potentially slow structural progression of osteoarthritis.

Research from Nature Portfolio

A 2024 cross-sectional analysis explored how Achilles tendon thickness correlates with knee function and foot alignment in osteoarthritis patients. Larger tendon cross-sectional dimensions were linked to altered forefoot and midfoot angles, reduced ankle range of motion and poorer scores on knee outcome scales. Multivariable models identified tendon thickness, navicular height ratio and ankle mobility as independent predictors of symptom severity and functional impairment. This work highlights the interdependence of distal tendon properties and proximal joint mechanics, suggesting that targeted interventions addressing both tendon health and foot posture may yield synergistic improvements in knee osteoarthritis management.

Biomechanical Interventions for Knee Osteoarthritis Management publication trend

The graph below shows the total number of articles in biomechanical interventions for knee osteoarthritis management across all publications each year (not limited to Nature Index journals).

Technical terms

External knee adduction moment (KAM): the rotational force around the knee in the frontal plane that reflects medial compartment loading during gait.

Valgus/Varus alignment: lateral (valgus) or medial (varus) deviation of the tibia relative to the femur in the frontal plane, influencing load distribution.

Gastrocnemius muscle–tendon unit stiffness: resistance of the calf muscle and its tendon to deformation under load, affecting shock absorption and joint loading.

Orthosis: an external device, such as a brace or insole, designed to support or correct musculoskeletal alignment and function.

Plantar pressure: distribution of force across the sole of the foot during standing and gait, reflecting load transfer through the lower limb.

References

1. Determinants of Achilles tendon thickness and their influence on knee function and foot alignment in knee osteoarthritis. Scientific Reports (2024).
2. Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials. Osteoarthritis and Cartilage (2024).
3. Identifying changes in dynamic plantar pressure associated with radiological knee osteoarthritis based on machine learning and wearable devices. Journal of NeuroEngineering and Rehabilitation (2024).
4. Knee braces and foot orthoses multimodal 3‐month treatment of medial knee osteoarthritis in a randomised crossover trial. Knee Surgery, Sports Traumatology, Arthroscopy (2024).