Long-term effects of lateral wedge orthotics on hip and ankle joint space widths.
Lateral wedge insoles have been used for the treatment of medial knee osteoarthritis (OA) and have been shown to reduce loading of the medial compartment of the knee. However, as the entire lower extremity acts as a single kinetic chain, altering the biomechanics of the knee may also have significant effects at the ankles or hips. We aimed to evaluate the effects of lateral wedge orthotics on ankle and hip joints, compared to neutral orthotics, by assessing the changes in joint space width (JSW) during 36 months of continuous use.



We prospectively enrolled 109 subjects with symptomatic osteoarthritis of the medial knee according to the American College of Rheumatology criteria. The trial was double blind and patients were randomized to either wedged or neutral orthotic shoe inserts. Hip and ankle JSWs were quantified using plain radiographies at baseline and at 36-months follow-up.



45 patients completed the 36 month study. 31 of those who completed the study were using the lateral wedge versus 14 were using neutral orthotics. 2 patients in the wedge group had missing radiographs and were not included in the JSW analyses. There were no significant differences between the wedge and the neutral orthotics groups in the magnitude of JSW change at either the hip or the ankles at 36 month.



We found no significant adverse effects of the lateral wedges on ankles or hips. (ClinicalTrials.gov NCT00076453).
Gazi University, School of Medicine, Department of Internal Medicine, Section of Rheumatology, Ankara, Turkey.
Mehmet E
ME
Tezcan
Gazi University, School of Medicine, Department of Internal Medicine, Section of Rheumatology, Ankara, Turkey. Electronic address: bgoker@yahoo.com.
Berna
B
Goker
Rush Medical College, Department of Internal Medicine, Section of Rheumatology, Department of Biochemistry, Chicago, IL, USA.
Roy
R
Lidtke
Rush Medical College, Department of Internal Medicine, Section of Rheumatology, Department of Biochemistry, Chicago, IL, USA.
Joel A
JA
Block
D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D004311:Double-Blind Method; D005260:Female; D061826:Foot Orthoses; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D011859:Radiography; D012775:Shoes
Joint space widths; Orthotics; Osteoarthritis
J Rheumatol. 1996 Oct;23 (10 ):1756-64
8895154
Osteoarthritis Cartilage. 2007 Aug;15(8):932-6
17391994
Ann Rheum Dis. 2011 Nov;70(11):1884-6
21908453
Clin Orthop Relat Res. 2009 Aug;467(8):2083-9
19381746
J Orthop Res. 2012 Jul;30(7):1125-32
22161816
Clin Biomech (Bristol, Avon). 2014 Jun;29(6):650-6
24861826
Osteoarthritis Cartilage. 2015 Aug;23(8):1316-22
25749010
Osteoarthritis Cartilage. 2001 Nov;9(8):738-45
11795993
Osteoarthritis Cartilage. 1995 Sep;3 Suppl A:3-70
8581752
BMC Musculoskelet Disord. 2014 Dec 03;15:405
25467955
Arthritis Rheum. 1986 Aug;29(8):1039-49
3741515
Ann Rheum Dis. 2010 Nov;69(11):1940-5
20511608
J Orthop Res. 2007 Sep;25(9):1121-7
17469197
PM R. 2012 May;4(5 Suppl):S89-96
22632708
Arthritis Rheum. 2000 May;43(5):988-94
10817550
J Rheumatol. 2013 Mar;40(3):309-15
23322462
Arthritis Rheum. 2007 Apr;56(4):1198-203
17393448
Prosthet Orthot Int. 2009 Jun;33(2):107-16
19367514
J Rheumatol. 2001 Dec;28(12 ):2705-10
11764221
J Orthop Res. 2011 Dec;29(12):1910-5
21656850
Osteoarthritis Cartilage. 2006 Mar;14(3):231-7
16271485
Arthritis Care Res (Hoboken). 2016 Jul;68(7):936-51
26605535
Arthritis Care Res (Hoboken). 2012 Apr;64(4):465-74
22563589
Rev Rhum Engl Ed. 1997 Dec;64(12 ):795-803
9476268
J Rheumatol Suppl. 1995 Feb;43:56-9
7752139
Clin Biomech (Bristol, Avon). 2012 Jan;27(1):27-33
21862189
JAMA. 2013 Aug 21;310(7):722-30
23989797
N Engl J Med. 1989 May 18;320(20):1322-30
2654632