Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: a randomized controlled trial

ABSTRACT Background: The increase in rates of knee replacement for osteoarthritis has made the identification of effective nonsurgical treatments a high priority. One type of treatment for medial knee osteoarthritis involves reducing medial loading to ease the physical stress applied to that compartment of the joint. The wedge is placed under the sole of the foot and angulated so that it is thicker over the lateral than the medial edge, transferring loading during weight bearing from the medial to the lateral knee compartment. This study aimed to investigate the effect of lateral wedge insole uptake in reducing pain in patients with knee osteoarthritis. Subjects and Method: A meta-analysis and systematic review conducted by search published articles from PubMed, Science Direct, Google Scholar, Mendeley, and Clinical key databases. Keywords used “Lateral Wedge Insole” OR “Insole” AND “Foot Orthosis “AND “osteoarthritis” AND “patellofemoral osteoarthritis” AND “knee pain” AND “medial knee osteoarthritis “AND” effect lateral wedge insole for osteoarthritis” AND “randomized controlled trial”. The inclusion criteria were full text, using randomized controlled trial (RCT) study design, and reporting effect size (mean and standard deviation). The intervention was lateral wedge insole with comparison non lateral wedge insole. The study outcome was pain. The data were analyzed by Revman 5.3. Results: 6 studies were met the inclusion criteria. This study showed that the use of lateral wedge insole reduced pain in patients with knee osteoarthritis (Mean Difference= -0.17; 95% CI= -0.51 to 0.18; p= 0.340) with heterogeneity I2= 77%. Conclusion: Lateral wedge insole use reduced pain in patients with knee osteoarthritis. Keywords: knee osteoarthritis, lateral wedge insole, randomized control trial Correspondence: Muhibbah Fatati, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 089633466598. DOI: https://doi.org/10.26911/the7thicph.05.45

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Is a high tibial osteotomy (HTO) superior to non-surgical treatment in patients with varus malaligned medial knee osteoarthritis (OA)? A propensity matched study using 2 randomized controlled trial (RCT) datasets

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2017.09.003 ◽

2017 ◽

Vol 25 (12) ◽

pp. 1988-1993 ◽

Cited By ~ 11

Author(s):

M.V. van Outeren ◽

J.H. Waarsing ◽

R.W. Brouwer ◽

J.A.N. Verhaar ◽

M. Reijman ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Surgical Treatment ◽

Knee Osteoarthritis ◽

High Tibial Osteotomy ◽

Controlled Trial ◽

Tibial Osteotomy ◽

Medial Knee ◽

Randomized Controlled ◽

Matched Study ◽

Non Surgical Treatment

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A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

Clinical Rehabilitation ◽

10.1177/0269215521993636 ◽

2021 ◽

pp. 026921552199363

Author(s):

Martin Schwarze ◽

Leonie P Bartsch ◽

Julia Block ◽

Merkur Alimusaj ◽

Ayham Jaber ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Controlled Trial ◽

Oxford Knee Score ◽

Knee Adduction Moment ◽

Osteoarthritis Of The Knee ◽

Knee Score ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Patient Reported ◽

Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

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