PTRCTGait & posture2017

Long-term effects of lateral wedge orthotics on hip and ankle joint space widths.

Mehmet E Tezcan, Berna Goker, Roy Lidtke and 1 others

PMID 27693959

WHAT IT FOUND

Lateral wedge insoles did not differ from neutral insoles in hip or ankle joint space width changes over 36 months.

Both groups had hip narrowing, and ankle joint spaces did not change, so no wedge-specific hip or ankle change was shown.

Key findings

01Lateral wedge orthotics did not differ from neutral orthotics in hip or ankle joint space width changes over 36 months.

02By 36 months, hip joint space narrowing occurred in both the lateral wedge and neutral orthotic groups, at the index and contralateral sides.

03Ankle joint space widths did not change in either group, and there were no increased reports of pain, injury or dysfunction of lower extremity joints or spine.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The dropout rate was higher than expected. 45 patients completed the 36-month study. Two lateral wedge patients had missing radiographs and were not included in joint space width analyses. The completed sample was small, so a real subtle effect could have been missed. The authors did not evaluate the nature of biomechanical changes in ankle joints while using lateral wedge insoles. The three-year duration made strict follow-up difficult.

Declared interests

The authors declared no conflicts of interest. The study was supported by NIH grant AR 051359, the Arthritis Foundation, Rush University, and Oakville Orthotics and Prosthetics.

The easy way to misread this

Do not read the lack of group difference as proof that lateral wedge insoles are safe for hips or ankles. The study was small, dropouts were high, and it only compared hip and ankle joint space width changes with neutral insoles.

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