Prospective study on the effects of orthotic treatment for medial knee osteoarthritis in Chinese patients: clinical outcome and gait analysis

A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis

“…[49] The inclination angles of insoles ranged from 3 degrees [43] to 11 degrees [37] and the most common angle was 5 degrees. [21,44,46,52] With regard to the medial arch support, 5 used a custom design based on patient comfort, [16,21,23,42,43] and 3 studies used prefabricated arch supports. [37,45,52] The remaining study did not report these data.…”

“…[37,45,52] The remaining study did not report these data. [44] Only 1 study used a flat insole as the comparison condition, [23] 3 studies used neutral insoles, [37,42,45] and 5 studies [16,21,43,44,52] used standardized footwear or patients’ usual shoes. Only 2 studies reported the height of the arch support [37,42] and 3 studies reported the density of the lateral wedge [42,43,46] (Table 1).…”

“…Only 2 studies reported the height of the arch support [37,42] and 3 studies reported the density of the lateral wedge [42,43,46] (Table 1). [16,21,23,37,42–45,52] …”

“…Compared to surgical strategies such as high tibial osteotomy (HTO), unicompartmental knee replacement or total knee replacement aiming to alter static lower extremity alignment, orthotic treatment like knee braces or foot insoles can alter loading to the knee in the hope of reducing symptoms and disease progression. [23] The lateral wedge insole (LWI) is a wedge placed under the sole of the foot and angulated so that it is thicker at the lateral part than the medial edge, transferring loading from the medial to the lateral knee joint during weight bearing. Although different groups have promulgated different recommendations, [24–26] biomechanical studies have demonstrated an effect size in reduction of EKAM ranging from 4% to 12% with an LWI of at least 5 degrees.…”

“…Recent studies have tested the effect on EKAM of adding an arch support to the LWI during gait but showed inconsistent findings. [21,23,29,37–46] Some authors found a reduction in the EKAM during the stance phase of gait using a lateral wedge and an arch support. [21,39–42,44–46] However, in some patients, no reductions [23,28] or smaller reductions [46] on the EKAM were observed.…”