Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow Jrheum on BlueSky
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
Research ArticleArticle
Open Access

A New Approach to Prevention of Knee Osteoarthritis: Reducing Medial Load in the Contralateral Knee

Richard K. Jones, Graham J. Chapman, Andrew H. Findlow, Laura Forsythe, Matthew J. Parkes, Jawad Sultan and David T. Felson
The Journal of Rheumatology January 2013, jrheum.120589; DOI: https://doi.org/10.3899/jrheum.120589
Richard K. Jones
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Graham J. Chapman
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew H. Findlow
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Laura Forsythe
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthew J. Parkes
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jawad Sultan
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David T. Felson
From the University of Salford, School of Health Sciences, Salford; and Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Supported by a program grant from Arthritis Research UK (grant 18676) and by US National Institutes of Health (grant AR47785). R.K. Jones, PhD, University of Salford, School of Health Sciences, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; G.J. Chapman, PhD; A.H. Findlow, PhD, University of Salford, School of Health Sciences; L. Forsythe, BSc; M.J. Parkes, BSc; D.T. Felson, MD, Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester; J. Sultan, MBBS, MRCS (Ed), MSc, University Hospital of South Manchester, Wythenshawe Hospital, Department of Orthopaedics, Manchester. Address correspondence to Dr. R.K. Jones, Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK. E-mail: r.k.jones@salford.ac.uk Full Release Article. For details see Reprints/Permissions at jrheum.org Accepted for publication November 21, 2012.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
Next
Loading

Abstract

Objective Few if any prevention strategies are available for knee osteoarthritis (OA). In those with symptomatic medial OA, the contralateral knee may be at high risk of disease, and a reduction in medial loading in that knee might prevent disease or its progression there. Our aim was to determine how often persons with medial OA on 1 side had either concurrent or later medial OA on the contralateral side, and whether an intervention known to reduce medial loading in affected knees with medial OA might reduce medial loading in the contralateral knee. Lateral wedge insoles reduce loading across an affected medial knee but their effect on the contralateral knee is unknown.

Methods To determine the proportion of persons with medial knee OA who had concurrent medial contralateral OA or developed contralateral medial OA later, we examined knee radiographs from the longitudinal Framingham Osteoarthritis Study. Then, to examine an approach to reducing medial load in the contralateral knee, 51 people from a separate study with painful medial tibiofemoral OA underwent gait analysis wearing bilateral controlled shoes with no insoles, and then with 2 types of wedge insoles laterally posted by 5°. Primary outcome was the external knee adduction moment (EKAM) in the contralateral knee. Nonparametric CI were constructed around the median differences in percentage change in the affected and contralateral sides.

Results Of Framingham subjects with medial radiograph knee OA, 137/152 (90%) either had concurrent contralateral medial OA or developed it within 10 years. Of those with medial symptomatic knee OA, 43/67 (64%) had or developed the same disease state in the contralateral knee. Compared to a control shoe, medial loading was reduced substantially on both the affected (median percentage EKAM change –4.84%; 95% CI –11.33% to –0.65%) and contralateral sides (median percentage EKAM change –9.34%; 95% CI –10.57% to –6.45%).

Conclusion In persons with medial OA, the contralateral knee is also at high risk of medial OA. Bilateral reduction in medial loading in knees by use of strategies such as lateral wedge insoles might not only reduce medial load in affected knees but prevent knee OA or its progression on the contralateral side.

Next
Back to top

In this issue

The Journal of Rheumatology: 52 (7)
The Journal of Rheumatology
Vol. 52, Issue 7
1 Jul 2025
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
A New Approach to Prevention of Knee Osteoarthritis: Reducing Medial Load in the Contralateral Knee
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
A New Approach to Prevention of Knee Osteoarthritis: Reducing Medial Load in the Contralateral Knee
Richard K. Jones, Graham J. Chapman, Andrew H. Findlow, Laura Forsythe, Matthew J. Parkes, Jawad Sultan, David T. Felson
The Journal of Rheumatology Jan 2013, jrheum.120589; DOI: 10.3899/jrheum.120589

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
A New Approach to Prevention of Knee Osteoarthritis: Reducing Medial Load in the Contralateral Knee
Richard K. Jones, Graham J. Chapman, Andrew H. Findlow, Laura Forsythe, Matthew J. Parkes, Jawad Sultan, David T. Felson
The Journal of Rheumatology Jan 2013, jrheum.120589; DOI: 10.3899/jrheum.120589
del.icio.us logo Twitter logo Facebook logo  logo Mendeley logo
  • Tweet Widget
  •  logo
Bookmark this article

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Multivariable Models to Predict a Diagnosis of Giant Cell Arteritis: Systematic Review and Metaanalysis
  • Prevalence and Predictors of Achieving Sustained Remission in Psoriatic Arthritis: A Swedish Nationwide Registry Study
  • Development of the Australian Rheumatology Association Clinical Care Standard for the Diagnosis and Management of Rheumatoid Arthritis in Adults
Show more Articles

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2025 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire