Lnfluence of concomitant heeled footwear when wearing a lateral wedged insole for medial compartment osteoarthritis of the knee

Objective: To compare the influence of concomitant heeled footwear when wearing a lateral wedged insole for medial compartment of osteoarthritis (OA) of the knee, between everyday walking shoes for outdoor use and socks or flat footwear without a heel for indoor use. Design: A total of 227 outpatients were prospectively randomized and treated with a neutral wedged insole inserted into shoes (placebo with shoes; n = 45), a wedged insole inserted into shoes (inserted insole with shoes; n 45), a sock-type ankle supporter with a wedged insole when wearing socks or f lat footwear (inserted insole without shoes; n 46), a subtalar strapped insole when wearing shoes (strapped insole with shoes; n = 45), and the strapped insole with socks or flat footwear (strapped insole without shoes; n = 46). The Lequesne index of knee OA at week 12 was compared with the baseline in each treatment group. Results: Twenty patients withdrew from the study, and the 207 patients who completed the 12-week study were evaluated. At the final assessment, participants wearing the inserted insole without shoes (P = 0.003), the strapped insole with shoes (P < 0.0001), and the strapped insole without shoes (P < 0.0001) demonstrated significantly improved Lequesne index scores in comparison with their baseline assessments. No significant differences were found in the placebo (P = 0.16) or the inserted insole with shoes (P=0.2) groups. Conclusion: Concomitant heeled footwear may decrease the efficacy of an inserted lateral wedged insole. The optimal usage of a lateral wedged insole for knee CA would be the combination with socks or flat footwear without heels. (c) 2007 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.