Effects of laterally wedged insoles on knee and subtalar joint moments

Arch Phys Med Rehabil. 2005 Jul;86(7):1465-71. doi: 10.1016/j.apmr.2004.09.033.


Objective: To assess the biomechanic effects of wearing a lateral wedge on the knee joint varus moment during gait in elders with and without knee osteoarthritis (OA).

Design: Crossover design whereby subjects walked under 2 different insole conditions: a 0 degrees control wedge and a 6 degrees lateral wedge.

Setting: A gait laboratory with 3-dimensional motion analysis and force platform equipment.

Participants: Thirteen healthy subjects and 13 knee patients with OA.

Interventions: Not applicable.

Main outcome measures: Frontal plane angles and moments at the knee and subtalar joints, ground reaction forces, and center of pressure. Moments were derived by using a 3-dimensional inverse dynamics model of the lower extremity.

Results: The 6 degrees lateral wedge significantly reduced knee joint varus moment and increased subtalar joint valgus moment in both groups when compared with no wedge. All patients had a greater knee joint varus moment with a similar subtalar joint valgus moment compared with the people without OA. There were diverse, sometimes reversed effects with the insole among the patients.

Conclusions: The 6 degrees lateral wedge did not consistently reduce the knee joint varus moment in patients with knee OA. The biomechanic indications and limitations of laterally wedged insoles should be confirmed by a larger study.

MeSH terms

  • Biomechanical Phenomena
  • Case-Control Studies
  • Cross-Over Studies
  • Female
  • Gait / physiology*
  • Humans
  • Joint Instability / physiopathology
  • Joint Instability / rehabilitation*
  • Knee Joint / physiopathology*
  • Middle Aged
  • Orthotic Devices*
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / rehabilitation*
  • Shoes*