National Institute for Health Research Biomedical Research Centre

Clinical trial shows treatment promise for patients with knee osteoarthritis

Research, supported by the Manchester BRC, and published in Arthritis & Rheumatology, shows for the first time that lateral wedge shoe insoles are effective in reducing pain in people with knee osteoarthritis (OA).

About one in eight people, aged 60 years and over, suffer from painful knee OA.   Current treatments for the disease are limited, often by lack of effect and side effects, and new treatments are badly needed.

A lateral wedge shoe insole is a simple and relatively low cost potential therapy.   It is thought to work by altering the biomechanics of the knee to reduce loading and therefore pain.

Previous studies, looking at the effect of the therapy, did not suggest any beneficial effect; however these studies did not pre-screen people to exclude those for whom the insole had no biomechanical effect.

Researchers at The University of Manchester set out to prove that wearing lateral wedge insoles would reduce knee pain if their use was restricted to people who were more likely to benefit from them.

Sixty two people who, on formal testing in a gait laboratory, showed a favourable biomechanical response to the lateral wedge insoles were included in the trial.  They were randomised to either a lateral wedge, or a neutral sole, for an 8 week period and then, following a short break, switched to the alternative therapy.  Participants were asked to wear the insoles for at least fours a day.

The trial showed that the lateral wedge insoles produced a small though greater reduction in knee pain than neutral insoles.

Professor David Felson, Degenerative Joint Disease Programme Lead and Lead Author, said “In this trial we found a small effect of lateral wedge shoe insoles on pain reduction in people with painful knee OA.  We think the beneficial effect may have been missed in previous studies because there was no pre-screening to see who might benefit.

“Our study offers promise for a simple, inexpensive treatment.  Further refinement, with use of specific shoes or increases in the degree of wedging, may increase efficacy.”

To read more about the research – The Efficacy of a Lateral Wedge Insole for Painful Medial Knee Osteoarthritis after Pre-screening: A Randomised Clinical Trial – click here