Effects of orthopedic insoles on patients with knee osteoarthritis: A meta-analysis and systematic review
Long Yu, Yanmin Wang, Jianzhong Yang, Jie Wang, Ying Zhang
Department of Rehabilitation, Shanghai Xuhui Central Hospital, 200031 Shanghai, China.
Objective: Recent clinical evidence supports that orthopaedic insoles, especially lateral-wedge insoles, can significantly benefit patients with knee osteoarthritis. The aim of this study is to explore the effects of orthopaedic insoles in patients with knee osteoarthritis.
Methods: Randomized controlled trials evaluating the effects of orthopaedic insoles on patients with knee osteoarthritis, published up to 16 February 2021, were reviewed and outcomes quantitatively summarized.
Results: A total of 15 studies from 13 randomized controlled trials that involved 1,086 participants were included in this study. All the included studies exhibited a moderate bias risk and were of acceptable quality. The pooled mean difference of pain determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was –1.21 (p < 0.001, 95% confidence interval (95% CI) –2.61–0.18) with a high heterogeneity (I2 = 75%). In the sensitivity analysis, the overall incidence was –0.20 (p= 0.62, 95% CI= –0.87–0.46) with an accepted heterogeneity (I2 = 0%). No difference was observed between the Asian and Caucasian groups (p= 0.28). No significant difference was found in the pain score, Lequesne index or functional improvements.
Conclusion: Meta-analysis revealed that orthopaedic insoles do not provide relief of pain or improve functionality in patients with knee osteoarthritis
Osteoarthritis of the knee joint is a progressive degenerative disease, which is fairly common in older adults, and leads to major pain and disability. The development and progression of knee osteoarthritis is exacerbated by excessive load on the medial knee joint. Various forms of orthopaedic insoles, such as insoles that provide arch support, shock-absorbing insoles, and lateral-wedge insoles, are widely used by patients with knee osteoarthritis, and are claimed to provide comfort and better support during walking. However, this meta-analysis and systematic review of randomized controlled trials evaluating the effects of orthopaedic insoles on knee osteoarthritis patients found that orthopaedic insoles do not provide relief of pain or improve functionality in patients with knee osteoarthritis.
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