Abstract
ObjectiveThe study aimed to evaluate the role of lateral-wedge insoles in pain reduction and functional improvement among patients with medial knee osteoarthritis.Materials and methodsThree databases including Pubmed, Embase, and Web of science were searched from inception until October 2017 for studies investigating the role of lateral-wedge treatment in pain relief and functional recovery among patients with knee osteoarthritis. Eligible studies were pooled using fixed effect model or random-effects model based on Cochrane Q statistic and I2 test. Moreover, subgroup analysis stratified by research area was performed, and sensitivity analysis was further designed to evaluate the strength of the meta-analysis.ResultsTen studies with a total of 938 patients, of which 478 patients received lateral-wedge insoles and 460 patients were set as control, were included in the meta-analysis. The pooled statistics did not show significant improvement in knee pain (SMD = − 0.21, 95% CI − 0.50, 0.08; P = 0.16) and knee function (SMD = 0.22, 95% CI − 0.27, 0.70; P = 0.38) in lateral-wedge insoles treatment group compared with controls. However, subgroup analysis based on research area revealed a favorable outcome toward Asian patients who received lateral-wedge insoles in pain reduction when compared with control group. (SMD = − 0.88, 95% CI − 1.59, − 0.17; P = 0.02). No significant improvement was observed among patients in USA and other areas. Sensitivity analysis showed unchanged results when we omitted each study. No significant publication bias was observed among the included studies.ConclusionThough for young Asian patients within normal BMI, to some extent, the lateral-wedge insoles seems to be helpful. However, there was no evidence to demonstrate the relationship between race and role of lateral-wedge insoles on pain reduction. All in all, based on current data, lateral-wedge insoles appear to be ineffective at attenuating knee pain and function improvement.
Highlights
Materials and methodsIn the elderly population, osteoarthritis (OA) is a major chronic musculoskeletal pain leading to restricted movement and decreased physical activity [1]
A review study suggested that the decreased load of the medial compartment in medial osteoarthritis patients with valgus brace or lateral wedge is beneficial for functional recovery and pain relief to some extent [5,6,7,8,9]
Subgroup analysis on studies conducted with Asian population showed significant pain reduction in patients after lateral-wedge insoles treatment compared with controls (SMD = − 0.88, 95% confidence intervention (95% CI) − 1.59, -− 0.17; P = 0.02)
Summary
Osteoarthritis (OA) is a major chronic musculoskeletal pain leading to restricted movement and decreased physical activity [1]. A review study suggested that the decreased load of the medial compartment in medial osteoarthritis patients with valgus brace or lateral wedge is beneficial for functional recovery and pain relief to some extent [5,6,7,8,9]. Others studies suggested that patients achieved little pain reduction after using wedged insoles compared with a control treatment [15]. These inconsistent outcomes might cause by various factors, such as patients’ ethnicity, country of residence, treatment duration, and the physical distribution. We aimed to assess the efficacy of lateral-wedge treatments as an independent therapy in knee pain reduction and function improvement for OA patients
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