Evidence map›Paper›PMID 40816302›Full record

Trial reportThe Lancet. Rheumatology2025

Personalised gait retraining for medial compartment knee osteoarthritis: a randomised controlled trial.

Scott D Uhlrich, Valentina Mazzoli, Amy Silder, Andrea K Finlay, Feliks Kogan, Garry E Gold, Scott L Delp, Gary S Beaupre, Julie A Kolesar

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. A biomechanical digital twin of Legg-Calvé-Perthes disease deformity.International journal of computer assisted radiology and surgery · 2026
    Article
  9. Observational
  10. Retraining Gastrocnemius Muscle Coordination Reduces Late-Stance Knee Contact Force in Individuals With Knee Osteoarthritis.IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society · 2026
    Article
  11. Therapeutic Footwear for Medial Knee Osteoarthritis: Individualizing Midsole Stiffness Enhances Intended Kinetic Changes.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026
    Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Ankle Exoskeleton Assistance Reduces Knee Contact Force During Walking in Individuals With Cerebral Palsy.IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Scott D UhlrichMusculoskeletal Research Laboratory, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA; Departments of Mechanical Engineering, Stanford University, Stanford, CA, USA; Bioengineering, Stanford University, Stanford, CA, USA; Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, USA. Electronic address: scott.uhlrich@utah.edu.
Valentina MazzoliMusculoskeletal Research Laboratory, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA; Radiology, Stanford University, Stanford, CA, USA.
Amy SilderMusculoskeletal Research Laboratory, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA; Bioengineering, Stanford University, Stanford, CA, USA.
Andrea K FinlayCenter for Innovation to Implementation, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA.
Feliks KoganRadiology, Stanford University, Stanford, CA, USA.
Garry E GoldRadiology, Stanford University, Stanford, CA, USA.
Scott L DelpDepartments of Mechanical Engineering, Stanford University, Stanford, CA, USA; Bioengineering, Stanford University, Stanford, CA, USA; Radiology, Stanford University, Stanford, CA, USA; Orthopaedic Surgery, Stanford University, Stanford, CA, USA.
Gary S BeaupreMusculoskeletal Research Laboratory, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA; Bioengineering, Stanford University, Stanford, CA, USA.
Julie A KolesarMusculoskeletal Research Laboratory, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA; Bioengineering, Stanford University, Stanford, CA, USA.

Funding

Technology DevelopmentP2CHD101913 · NICHD · STANFORD UNIVERSITY · PI DELP, SCOTT L · 2020 to 2024
$4.1M
NICHD NIH HHS P2C HD101913RRD VA I01 RX001811
6 · The paper itself

Abstract

backgroundRetraining individuals with medial compartment knee osteoarthritis to walk with a patient-specific change in their foot angle (ie, toe-in or toe-out angle) can reduce excessive joint loading related to disease progression. This study investigated the clinical, biomechanical, and structural efficacy of personalised foot progression angle modifications compared with sham treatment in patients with mild-to-moderate medial compartment knee osteoarthritis.

methodsIn this single-center, parallel-group, randomised controlled trial, we recruited individuals with symptomatic medial compartment knee osteoarthritis at the Human Performance Laboratory and Lucas Center for Imaging at Stanford University, CA, USA, using online and print media. Eligible participants (aged ≥18 years) were randomly assigned (1:1) by a computer to an intervention or sham group. During six walking retraining visits to a university gait laboratory, all participants received real-time biofeedback instructing them to walk consistently with a personalised target foot progression angle. The intervention group's target was the 5° or 10° change in foot progression angle that maximally reduced their knee loading, and the sham group's target was their natural foot progression angle. Participants and staff involved in data analysis were masked to group allocation; staff performing the gait analysis visits were not. Primary outcomes were 1-year changes in medial knee pain (numeric rating scale) and medial knee loading (knee adduction moment peak). Secondary outcomes were 1-year changes in cartilage microstructure estimated from MRI (T

findingsBetween Aug 1, 2016, and June 25, 2019, 1582 individuals were screened for eligibility. 107 participants completed an initial gait analysis and 68 were randomly assigned to either the intervention (n=34) or the sham (n=34) group. 41 (60%) of 68 participants were female, 27 (40%) were male, and 54 (79%) were White; mean age was 64·4 years (SD 7·6). After 1 year, participants in the intervention group had greater reductions in medial knee pain (between-group difference -1·2, 95% CI -1·9 to -0·5; p=0·0013) and knee adduction moment peak (between-group difference -0·26 % bodyweight × height, 95% CI -0·39 to -0·13; p=0·0001) than participants in the sham group. The MRI-estimated change in cartilage microstructure (T

interpretationPersonalised foot angle modifications improve pain, reduce knee loading, and might slow osteoarthritis progression, making them a promising non-surgical treatment option for some individuals with medial compartment knee osteoarthritis.

fundingUS Department of Veterans Affairs.

Indexed as

Exercise TherapyGaitOsteoarthritis, KneeWalkingAgedBiofeedback, PsychologyBiomechanical PhenomenaFemaleHumansKnee JointMaleMiddle AgedTreatment Outcome

Identifiers

PMID40816302
PMCPMC13034617

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.