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Lateral wedge insoles deemed not effective for alleviating OA knee pain

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A meta-analysis published in the Journal of the American Medical Association revealed no significant difference between lateral wedge insoles and shoes with neutral insoles for the treatment of pain in patients with knee osteoarthritis.

“These results suggest that compared with control interventions, lateral wedges are not efficacious for the treatment of knee pain in persons with medial knee osteoarthritis,” Matthew J. Parkes, BSc, from the Arthritis Research UK Epidemiology Unit, at the University of Manchester in England, stated in a press release from the Journal of the American Medical Association.

Parkes and colleagues analyzed 12 randomized controlled trials with a total of 885 participants. Of those participants, 502 received lateral wedge insoles as a conservative treatment for their pain. The meta-analysis included trials where a neutral, flat or no insole was used in a control group, and trials where most of patients’ pain originated from the medial compartment. The researchers identified patient-reported outcomes as the primary outcome for their analysis.

Compared to control groups and using the standard mean difference, Parkes and colleagues concluded there was a positive association with lateral wedges for relieving pain that resulted in an improvement in WOMAC scores by 2.12 points. However, “substantial heterogeneity was present” in the studies, according to the abstract.

Furthermore, they found that trials with a lower risk of bias showed no difference in results between control groups and participants with lateral wedges. In seven trials where a neutral insole acted as a control, there was no significant difference in outcomes between participants with lateral wedge insoles and the control group, according to the study abstract.
Reference:

Parkes MJ. J Am Med Assoc. 2013;doi:10.1001/jama.2013.243229.

Disclosure: The authors received grants for this study from Arthritis Research UK and the National Institute for Health and Clinical Excellence.