Lateral wedge shoe insoles for medial knee osteoarthritis: a 12‐month randomised controlled trial

Kim L Bennell,Kelly‐Ann Bowles,Rana S Hinman,Andrew Forbes,Fahad Hanna,Elizabeth Williamson,Flavia Cicuttini,Miranda Davies‐ Tuck,Craig Payne

doi:10.1186/1757-1146-4-s1-o7

Abstract

Methods A randomised participant- and assessor-blinded controlled trial was used. 200 people aged 50 or more with clinical and radiographic diagnosis of mild-to-moderately severe medial knee OA were recruited. The interventions consisted of full-length 5° lateral wedged insoles or flat control insoles worn inside the shoes daily for 12 months. The primary symptomatic outcome was change in overall knee pain (past week) measured on an 11-point numeric rating scale and primary structural outcome was change in medial tibial cartilage volume from magnetic resonance imaging. Secondary clinical outcomes included changes in measures of pain, function, stiffness, and health-related quality of life. Secondary structural outcomes included progression of medial cartilage defects and bone marrow lesions. Results There were no significant between-group differences for the primary outcomes of change in overall pain (-0.3 points 95% CI (-1.0 to 0.3)) and change in medial tibial

Highlights

The majority of clinical guidelines recommend lateral wedge shoe insoles for medial knee osteoarthritis (OA), despite limited and equivocal evidence of efficacy
In this study, lateral wedge insoles worn for 12 months provided no symptomatic or structural benefits compared to a flat control insole
Author details 1Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Victoria, Australia. 2Department of Podiatry & Musculoskeletal Research Centre, LaTrobe University, Melbourne, Australia. 3Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia. 4Health Economics Unit, Monash University, Melbourne, Australia. 5Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, Victoria 3004, Australia

Summary

Introduction

The majority of clinical guidelines recommend lateral wedge shoe insoles for medial knee osteoarthritis (OA), despite limited and equivocal evidence of efficacy. Lateral wedge shoe insoles for medial knee osteoarthritis: a 12-month randomised controlled trial Kim L Bennell1, Kelly-Ann Bowles1, Craig Payne2*, Flavia Cicuttini3, Elizabeth Williamson3, Andrew Forbes3, Fahad Hanna3,4,5, Miranda Davies- Tuck3, Rana S Hinman1 From Australasian Podiatry Council Conference 2011 Melbourne, Australia.

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Conclusion