Do Lateral Wedge Insoles Reduce Pain for Patients with Medial Knee Osteoarthritis?

Knee osteoarthritis associated with varus deformity and medial knee compartment collapse can cause disabling pain. To offload the medial compartment, a lateral wedge insole that diminishes varus deformity by 5 to 15 degrees often is used in the shoe of the affected leg, but recommendations by professional organizations are mixed, and most individual clinical trials have been negative. Now, investigators have conducted a meta-analysis of 12 randomized trials of lateral wedge insoles that involved 885 patients with painful medial knee osteoarthritis (one of those trials was summarized in NEJM JW Gen Med Jul 12 2011).

Study durations ranged from 2 weeks to 2 years, and treatment insoles lowered varus angulation by 5 to 6 degrees. Seven studies …