Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: a prospective randomized controlled study

Maillefert, Jean Francis; Hudry, Christophe; Baron, Gabriel; Kieffert, P.; Bourgeois, Pierre; Lechevalier, D.; Coutaux, A.; Dougados, Maxime

doi:10.1053/joca.2001.0470

Cited by 145 publications

(91 citation statements)

References 9 publications

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“…This dubiousness is supported by the fact that clinical studies about the effect of wedges come to controversial results. [8][9][10][11] Load reductions within or above 5-10% may also be achieved by other gait modifications such as increased lateral trunk lean, reduced walking speed or by using a contralateral crutch or cane. 33 Greater medial force reductions can also be expected when walking with (more inconvenient) valgus braces.…”

Section: Discussionmentioning

confidence: 99%

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The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Kutzner

Damm

Heinlein

et al. 2011

Journal Orthopaedic Research

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A conventional method to unload the medial compartment of patients with gonarthrosis and thus to achieve pain reduction is the use of laterally wedged shoes. Our aim was to measure in vivo their effect on medial compartment loads using instrumented knee implants. Medial tibio-femoral contact forces were measured in six subjects with instrumented knee implants during walking with the following shoes: without wedge, with 5 and 10 mm wedges under the lateral sole, and with a laterally wedged insole (5 mm). Measurements were repeated with the shoes in combination with an ankle-stabilizing orthosis. Without orthosis, peak medial forces were reduced by only 1-4% on average. With orthosis, the average reduction was 2-7%. Highest reductions were generally observed with the 10 mm wedge, followed by the 5 mm wedge, and the 5 mm insole. Individual force reductions reached up to 15%. Medial force reductions while walking with wedged shoes were generally small. Due to high inter-individual differences, it seems that some patients might benefit from lateral wedges, whereas others might not. Further analyses of the individual kinematics will show which factors are most decisive for the reduction of medial compartment load. ß

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Section: Discussionmentioning

confidence: 99%

“…Some studies showed that the use of lateral wedges led to significant pain reduction, [5][6][7] but no pain-relieving effect of lateral wedges was found by other short-and long-term studies. [8][9][10][11] Reductions of the peak EAM when walking with lateral wedges have been shown by several studies.…”

mentioning

confidence: 99%

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Kutzner

Damm

Heinlein

et al. 2011

Journal Orthopaedic Research

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“…Most new biomechanical evaluations of lateral wedges published since 2011 agree with these findings [41][42][43]. Unfortunately, the assumption that the loadreducing effects of lateral wedges will translate into clinically meaningful reductions in pain in people with knee OA has not been borne out in the clinical trials conducted to date [44][45][46][47]. Of note, the latest RCT, involving 200 people with medial knee OA and published in BMJ in 2011 [48 •• ], demonstrated that lateral wedges worn over 12 months do not significantly reduce pain or slow structural disease progression (as measured via cartilage volume on MRI).…”

Section: Role Of Footwear and Insoles In The Management Of Knee Oamentioning

confidence: 86%

Exercise, Gait Retraining, Footwear and Insoles for Knee Osteoarthritis

Hinman

Hunt²,

Simić

et al. 2013

Curr Phys Med Rehabil Rep

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Knee osteoarthritis (OA) is a chronic musculoskeletal condition that imposes a significant personal and societal burden worldwide. Contemporary management of the condition involves a range of non-pharmacological conservative rehabilitation strategies. Exercise, in particular, is integral for patients with knee OA. However, there has also been increasing interest in the role of gait retraining, footwear and insoles for managing knee OA because of their biomechanical effects at the knee joint and potential for altering disease progression. This review will highlight recent research findings and trends in these areas of exercise, gait retraining, footwear and insoles for managing knee OA.

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“…The effect on subjective scores showed significant improvements in some, 22 but not all studies. 23,24 Two randomised controlled trials by Maillefert et al 23 and Baker et al 24 did not show statistically significant changes in WOMAC scores with lateral-wedged insoles, although there was a significant reduction in non-steroidal antiinflammatory drug intake in the insole group.…”

mentioning

confidence: 96%

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

Fu¹,

Lie²,

Ng³

et al. 2015

Hong Kong Med J

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Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: a prospective randomized controlled study

Cited by 145 publications

References 9 publications

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

The effect of laterally wedged shoes on the loading of the medial knee compartment‐in vivo measurements with instrumented knee implants

Exercise, Gait Retraining, Footwear and Insoles for Knee Osteoarthritis

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

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