Comparison of the efficacy of laterally wedged insoles and bespoke unloader knee orthoses in treating medial compartment knee osteoarthritis

BACKGROUND: Patients suffering from medial compartment knee osteoarthritis (OA) may be treated with unloader knee orthoses or laterally wedged insoles. OBJECTIVES: The aim of this study was to identify and compare the effects of them on the gait parameters and pain in these patients. STUDY DESIGN: Quasi-experimental. METHODS: Volunteer subjects with medial compartment knee OA (n = 24, mean age 59.29 ± 2.23 years) were randomly assigned to two separate groups and evaluated when wearing an unloader knee orthosis or insoles incorporating a 6° lateral wedge. Testing was performed at baseline and after six weeks of each orthosis use. A visual analog scale score was used to assess pain and gait analysis was utilized to determine gait parameters. RESULTS: Both orthoses improved all parameters compared to the baseline condition (p = 0.000). However, no significant differences in pain (p = 0.649), adduction moment (p = 0.205), speed of walking (p = 0. 056) or step length (p = 0.687) were demonstrated between them. The knee range of motion (p = 0.000) were significantly different between the two interventions. CONCLUSION: Both orthoses reduced knee pain. Maximum knee range of motion was increased by both interventions although it was 3 degrees less when wearing the knee orthosis. Clinical relevance Both orthoses reduce pain and improve gait anomalies in medial compartment knee OA. Our results suggest a laterally wedged insole can be an alternative conservative approach to unloader knee orthosis for treating symptoms of medial compartment knee OA.