The effects of shoe-worn insoles on gait biomechanics in people with knee osteoarthritis: a systematic review and meta-analysis

Abstract

Objectives The effect of shoe-worn insoles on biomechanical variables in people with medial knee osteoarthritis has been studied extensively. The majority of research has focused specifically on the effect of lateral wedge insoles at the knee. The aim of this systematic review and meta-analysis was to summarise the known effects of different shoe-worn insoles on all biomechanical variables during level walking in this patient population to date. Methods Four electronic databases were searched to identify studies containing biomechanical data using shoe-worn insole devices in the knee osteoarthritis population. Methodological quality was assessed and a random effects meta-analysis was performed on biomechanical variables reported in three or more studies for each insole. Results Twenty-seven studies of moderate-to-high methodological quality were included in this review. The primary findings were consistent reductions in the knee adduction moment with lateral wedge insoles, although increases in ankle eversion with these insoles were also found. Conclusion Lateral wedge insoles produce small reductions in knee adduction angles and external moments, and moderate increases in ankle eversion. The addition of an arch support to a lateral wedge minimises ankle eversion change, and also minimises adduction moment reductions. The paucity of available data on other insole types and other biomechanical outcomes presents an opportunity for future research.

Anatomical Adaptation of Fibula and its Mechanism of Proximal Partial Fibulectomy Associated with Medial Compartment Knee Osteoarthritis

“…The lateral wedge insole used for knee OA patients was reported to significantly increase the amount of ankle/subtalar joint complex, resulting in lateral shift of the COP and reduction of KAM. However, accentuation of rearfoot pronation in already pronated feet could potentially result in higher talofibular contact pressure, causing ankle symptoms.…”

Footwear for osteoarthritis of the lateral knee: protocol for the FOLK randomised controlled trial

“…In people with medial knee OA, a number of studies have shown that lateral wedge insoles [15], flat flexible shoes [16], and shoes with midsoles that are stiffer laterally than medially redistribute knee load away from the medial TF compartment towards the lateral compartment [17], albeit clinical effects are uncertain [18]. This is achieved via a lateral shift in the frontal plane ground reaction force-knee joint centre lever arm [19,20] and an increase in lateral plantar pressures [21].…”

The effect of treatment with a non-invasive foot worn biomechanical device on subjective and objective measures in patients with knee osteoarthritis- A retrospective analysis on a UK population

“…Symptomatic knee OA has been shown to be in uenced by both biomechanical and neuromuscular treatments, which has led to conservative treatments currently available largely aim to in uence either one of these factors (20)(21)(22)(23)(24)(25)(26)(27). Interventions typically attempt to manipulate the KAM and KAAI loads transmitted through the joint, or improve the neuromuscular de cits seen within the pathology by muscle strengthening and proprioceptive exercises (28,29).…”