The optimal degree of lateral wedge insoles for reducing knee joint load: a systematic review and meta-analysis.

Most studies were single-group crossover designs and had unclear or high risk of bias in random sequence generation and allocation concealment. The outcomes were immediate biomechanical load measures, not pain, function or long-term clinical outcomes. The review included 15 studies with 415 participants, but the first peak external knee adduction moment meta-analysis reported n = 578 because some studies contributed multiple comparisons. Seven studies had small samples with fewer than 20 participants. Studies used different insole lengths, arch supports, control conditions, wedge angles and external knee adduction moment calculation methods, and comparison was difficult. The first peak external knee adduction moment analysis showed weak evidence of publication bias on Egger's test. The above 9 degrees subgroup for knee adduction angular impulse was based on only one study with 18 participants.

The supplied text does not state who funded this review or declare author conflicts. The included studies list funding sources in Table 2, including research councils, foundations, universities, Ergoresearch Inc and New Balance Athletic Shoe Inc.

Do not conclude that lateral wedge insoles treat knee osteoarthritis symptoms. This review measured immediate knee load during walking, and the authors note the load reduction may be too small to be clinically relevant for pain or symptoms.