The effectiveness of foot orthoses in the treatment of medial knee osteoarthritis: A systematic review
Zafar, A; Zamani, R; Akrami, M
Date: 19 December 2019
Article
Journal
Gait and Posture
Publisher
Elsevier
Publisher DOI
Abstract
Background: Knee osteoarthritis is a disease of the joint causing decreased function and pain.
Currently, treatments range from medication to surgery, with the use of different insoles and
footwear recommended. These methods are effective by either correcting the position of the
knee or providing shock absorption. However, there is ...
Background: Knee osteoarthritis is a disease of the joint causing decreased function and pain.
Currently, treatments range from medication to surgery, with the use of different insoles and
footwear recommended. These methods are effective by either correcting the position of the
knee or providing shock absorption. However, there is little understanding of the effective
characteristics of these devices.
Research question: This paper aims to investigate this question and provide future areas of
research to help better define treatment guidelines. Foot orthoses are an example of nonpharmacological conservative treatments mentioned in National Institute for Health and Care
Excellence (NICE) guidelines to treat knee osteoarthritis (OA). These include lateral wedge
insoles (LWI), developed with the intention of load reduction of the knee. Different footwear
has also been shown to affect pain, biomechanical and functional outcomes in knee OA
patients.
Methods: To address what features of LWIs and footwear make them effective in the treatment
of knee OA, scientific databases were used to search for papers on this topic and then selected
to be included based on pre-defined criteria. Data were extracted and analysed from these
studies to provide a basis for possible areas for future development of these foot orthoses, and
research required to improve clinical treatment guidelines. Databases used were PubMed,
Scopus and Web of Science.
Results and Significance: Thirty-four out of 226 papers were included after application of
inclusion and exclusion criteria. Regarding LWIs, the characteristics showing the most
beneficial effect on either biomechanical, functional or pain outcomes were customisation, fulllength, 5° elevation, shock absorption and arch support. For footwear, barefoot mimicking
soles produced the most favourable biomechanics. Results also showed that insoles work in
correcting the position of the knee, but it may or may not affect patients’ pain and function.
Engineering
Faculty of Environment, Science and Economy
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Except where otherwise noted, this item's licence is described as © 2019. This version is made available under the CC-BY-NC-ND 4.0 license: https://creativecommons.org/licenses/by-nc-nd/4.0/