Lateral Wedge Insoles
We cannot suggest that lateral wedge insoles be used for patients with symptomatic medial compartment osteoarthritis of the knee.
MODERATE RECOMMENDATION Rationale
This recommendation is based on five studies. Four studies, one of high-strength81 and three of moderate-strength, compared outcomes using lateral wedge insoles to neutral insoles.82-84 No significant changes in pain, self-reported physical function, or Patient Global Assessment scores were seen between the two types of insoles. A fifth low-strength study compared urethane lateral wedge insoles to rubber lateral insoles, and found a statistically significant improvement in Lequesne score for urethane insoles, but this outcome was of uncertain clinical significance.85
- (81) Bennell KL, Bowles KA, Payne C et al. Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial. BMJ 2011;342):d2912. PM:21593096
- (82) Baker K, Goggins J, Xie H et al. A randomized crossover trial of a wedged insole for treatment of knee osteoarthritis. Arthritis Rheum 2007;56(4):1198-1203. PM:17393448
- (83) Maillefert JF, Hudry C, Baron G et al. Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: a prospective randomized controlled study. Osteoarthritis Cartilage 2001;9(8):738-745. PM:11795993
- (84) Pham T, Maillefert JF, Hudry C et al. Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis. A two-year prospective randomized controlled study. Osteoarthritis Cartilage 2004;12(1):46-55. PM:14697682
- (85) Toda Y, Tsukimura N. A comparative study on the effect of the insole materials with subtalar strapping in patients with medial compartment osteoarthritis of the knee. Modern Rheumatology 2004;14(6):459-465.
- Toda Y,Tsukimura N. Influence of concomitant heeled footwear when wearing a lateral wedged insole for medial compartment osteoarthritis of the knee. Osteoarthritis Cartilage 2008;16(2):244-253.