Orthotics

OBJECTIVE: To determine the effects of lateral wedged insoles on knee kinetics and kinematics during walking, according to radiographic severity of medial compartment knee osteoarthritis (OA). DESIGN: A prospective case control study of patients with medial compartment OA of the knee. SETTING: Gait analysis laboratory in a university hospital. PARTICIPANTS: Forty-six medial compartment knees with OA of 23 patients with bilateral disease and 38 knees of 19 age-matched healthy subjects as controls...

PURPOSE OF REVIEW: This review highlights recent research findings, including their clinical application, for insoles and footwear in knee osteoarthritis. In particular, it examines their effect on knee load, osteoarthritis symptoms and disease progression. RECENT FINDINGS: Increased joint loading increases the risk of osteoarthritis progression, but is amenable to change. Given the prevalence of medial compartment osteoarthritis, insoles and footwear largely aim to reduce the knee adduction moment, an indicator of medial compartment load...

OBJECTIVE: To compare the influence of concomitant heeled footwear when wearing a lateral wedged insole for medial compartment of osteoarthritis (OA) of the knee, between everyday walking shoes for outdoor use and socks or flat footwear without a heel for indoor use. DESIGN: A total of 227 outpatients were prospectively randomized and treated with a neutral wedged insole inserted into shoes (placebo with shoes; n=45), a wedged insole inserted into shoes (inserted insole with shoes; n=45), a sock-type ankle supporter with a wedged insole when wearing socks or flat footwear (inserted insole without shoes; n=46), a subtalar strapped insole when wearing shoes (strapped insole with shoes; n=45), and the strapped insole with socks or flat footwear (strapped insole without shoes; n=46)...

The authors discuss the use of lateral heel wedges in the treatment of medial osteoarthritis of the knee in 121 knees in 85 patients. Follow-up was an average of 12 months after the insertion of the wedge. Patients' roentgenograms were graded according to the Ahlback classification, and various improvements were noted. Overall, 38% of patients improved to a Hospital for Special Surgery pain score of 25 or 30, which corresponds to an excellent result from total knee arthroplasty. Fifty percent of patients improved to a pain score of 20 or higher, which corresponds to a good result from total knee arthroplasty...

Sixty-two patients with early medial compartment osteoarthritis of the knee were treated with lateral heel wedges and followed for from 7 years and 5 months to 12 years. Those who were treated with heel wedges and analgesics showed a significantly greater improvement in pain score than those treated with analgesics only, but not in the walking ability score at the second follow up. The lateral heel wedge had no effect on the progress of the radiographic changes. The lateral heel wedge is useful for patients with early medical compartment osteoarthritis provided it is used with an understanding of the indications and its limitations...

IMPORTANCE: There is no consensus regarding the efficacy of lateral wedge insoles as a treatment for pain in medial knee osteoarthritis. OBJECTIVE: To evaluate whether lateral wedge insoles reduce pain in patients with medial knee osteoarthritis compared with an appropriate control. DATA SOURCES: Databases searched include the Cochrane Central Register of Controlled Trials, EMBASE, AMED, MEDLINE, CINAHL Plus, ScienceDirect, SCOPUS, Web of Science, and BIOSIS from inception to May 2013, with no limits on study date or language...