Comparing Two Orthoses for Managing Medial Knee Osteoarthritis: Lateral Wedge with Subtalar Strap While Barefoot Versus Lateral Wedged Insole Fitted Within Sandal

Background Using foot orthoses for managing medial knee osteoarthritis (MKOA) is common, although its effectiveness is in debate. Most orthoses are placed inside the shoe as a lateral wedged insole. Thus, most studies in this area have focused on the effect of insoles used with shoes. This study compared the effects of a lateral wedge with subtalar strap (combined insole) used while barefoot and lateral wedged insole fitted within sandal on pain, function and external knee adduction moment (EKAM) in patients with MKOA to consider which orthotic treatment is better. Methods In this quasi-experimental pretest-posttest study, 29 participants with medial knee osteoarthritis were divided into two groups: (1) combined insole (n = 15) and (2) sandal (n = 14) groups. We recorded their gait while walking with and without orthoses using a motion analysis system. We evaluated their pain and performance with visual analog scale, Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, 30 s chair stand, and Timed Up and Go functional tests. The pain and performance evaluations were repeated after one month. Results The pain immediately decreased after walking with both orthoses (p < 0.001). There was no significant difference in EKAM results between the two orthoses. Pain and performance improved in both groups after a one month using the orthoses (p < 0.01). Conclusion Both types of orthoses have similar effect and lead to better performance and less pain after 1 month.

Automated summary

This study compared the effects of a lateral wedge with subtalar strap used while barefoot and lateral wedged insole fitted within sandal on pain, function, and external knee adduction moment in patients with MKOA. The results showed that both types of orthoses had similar effects in reducing pain, improving function, and decreasing the external knee adduction moment, with significant improvements seen after one month of use.