Don’t use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.

In patients with symptomatic osteoarthritis of the knee, the use of lateral wedge or neutral insoles does not improve pain or functional outcomes. Comparisons between lateral and neutral heel wedges were investigated, as were comparisons between lateral wedged insoles and lateral wedged insoles with subtalar strapping. The systematic review concludes that there is only limited evidence for the effectiveness of lateral heel wedges and related orthoses. In addition, the possibility exists that those who do not use them may experience fewer symptoms from osteoarthritis of the knee.

 

Sources:

American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (non-arthroplasty): Full guideline [Internet]. 2008 Dec [cited 2014 Feb 20].

Baker K, et al. A randomized crossover trial of a wedged insole for treatment of knee osteoarthritis. Arthritis Rheum. 2007 Apr;56(4):1198-203. PMID: 17393448.

Bennell KL, et al. Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial. BMJ. 2011 May 18;342:d2912. PMID: 21593096.

Brouwer RW, et al. Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Syst Rev. 2005 Jan 25;(1)(1):CD004020. PMID: 15674927.

Maillefert JF, et al. Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: A prospective randomized controlled study. Osteoarthritis Cartilage. 2001 Nov;9(8):738-45. PMID: 11795993.

Nigg BM, et al. Unstable shoe construction and reduction of pain in osteoarthritis patients. Med Sci Sports Exerc. 2006 Oct;38(10):1701-8. PMID: 17019290.

Pham T, et al. Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis. A two-year prospective randomized controlled study. Osteoarthritis Cartilage. 2004 Jan;12(1):46-55. PMID: 14697682.

Richmond J, et al. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad Orthop Surg. 2009 Sep;17(9):591-600. PMID: 19726743.

Toda Y, et al. Usefulness of an insole with subtalar strapping for analgesia in patients with medial compartment osteoarthritis of the knee. Arthritis Rheum. 2002 Oct 15;47(5):468-73. PMID: 12382293.

Toda Y, et al. Effect of a novel insole on the subtalar joint of patients with medial compartment osteoarthritis of the knee. J Rheumatol. 2001 Dec;28(12):2705-10. PMID: 11764221.

Toda Y, et al. A 2-year follow-up of a study to compare the efficacy of lateral wedged insoles with subtalar strapping and in-shoe lateral wedged insoles in patients with varus deformity osteoarthritis of the knee. Osteoarthritis Cartilage. 2006 Mar;14(3):231-7. PMID: 16271485.

Toda Y, et al. A comparative study on the effect of the insole materials with subtalar strapping in patients with medial compartment osteoarthritis of the knee. Mod Rheumatol. 2004 Dec;14(6):459-65. PMID: 24387723.

Toda Y, et al. A six-month followup of a randomized trial comparing the efficacy of a lateral-wedge insole with subtalar strapping and an in-shoe lateral-wedge insole in patients with varus deformity osteoarthritis of the knee. Arthritis Rheum. 2004 Oct;50(10):3129-36. PMID: 15476225.