“Unloading Shoes”: No Benefit for Patients with Painful Knee Osteoarthritis

Clinical guidelines recommend appropriate shoes for patients with knee osteoarthritis (OA; Arthritis Care Res (Hoboken) 2012; 64:465). Most tibiofemoral OA occurs medially, so researchers in Australia randomized 164 patients (median age, 64) with medial knee OA on radiography and pain most days to wear “unloading shoes” — shoes whose soles have greater lateral than medial stiffness — or conventional walking shoes for at least 4 hours daily for 6 months.

Both groups wore their assigned shoes for about 7.5 hours daily. Ankle and foot pain were more common with unloading shoes than with walking shoes (20% vs. 9% of patients, respectively), and approximately half of patients in both groups reported improvements in pain and function at 6 months, …