Evaluating the Efficacy of Lateral Heel Wedges of Osteoarthritis of the Knee

Inclusion Criteria:

• Adult patients 30 years or older with medial compartment knee Osteoarthritis (unilateral) and Grade 4 Kellgren-Lawrence39 radiographic changes presenting for treatment of knee pain.
• Range of motion knee-flexion beyond 100 degrees and not lacking more than 15 degrees of extension.
• Subtalar and forefoot motion permitting foot/ankle eversion with weight bearing.
• Sufficient shoe toe box height to allow space for the insole and therefore comfort and compliance.
• Passive laxity of medial capsule and collateral ligament by knee extension test.

Exclusion Criteria:

• All other forms of knee arthritis other than OA.
• Knee Instability- medial pseudo-opening of greater than grade 1 or detectable Anterior-posterior instability.
• Less than Grade 4 Kellgren-Lawrence radiographic changes in the medial compartment of the knee39.
• Grade 2 or greater Kellgren-Lawrence radiographic39 involvement of the patellofemoral or lateral compartment.
• Inadequate knee range of motion
• Balance problems requiring the use of a walker or wheel chair - ambulation with aid
• Diabetics with peripheral neuropathy
• Knee surgery within the past year
• Intraarticular steroid injection or visco supplementation within 6 months
• Stiff subtalar or forefoot joints - clinical test
• Inadequate shoe toe box depth to accommodate the test or control inserts
• Charcot joint
• Fixed contracture of the medial capsule and/or collateral ligament- clinical test