Current Pedorthics | January-February 2019 | Vol.51, Issue 1 | Page 23

Lateral wedges - a crossover study NORMAL KNEE OSTEOARTHRITIS Femur Bone Spur Ligament Cartilage Medial Meniscus Degenerated Meniscus Degenerated Cartilage Lateral Meniscus Fibula Tibia "An examination of data from the Osteoarthritis Initiative showed that 25% of individuals with painful knee OA concurrently report foot pain, and that the presence of foot pain adversely affected overall health and function." knee OA research has been a failure to consider participants’ foot morphology in the study design and delivery of treatment. In clinical practice, pronated feet are typically managed with some form of medial arch support [15, 16], and while some research shows that beneficial changes in ankle kinematics [17] and foot pain [18, 19] may be obtained with this clinical approach in people with pronated feet, the evidence in this area is sparse [20]. However, there is potential that a combination of lateral wedges and arch supports may be beneficial for people with painful knee OA and pronated feet [21]. Given the apparent strong link between pronated foot type and disease characteristics specific to medial compartment knee OA, and that biomechanical interventions such as lateral wedges are advocated in clinical guidelines for the use of conservative treatments for knee OA in general [22], a better understanding of the clinical effects of shoe-worn insole treatment for in this specific subgroup of knee OA is warranted. Therefore, the purpose of the present exploratory randomized crossover study was to compare clinical effects (knee and foot symptoms) of lateral wedges alone to insoles that combined lateral wedging with customized arch support in people with medial Current Pedorthics | January/February 2019 21