Department of Rehabilitation, Shanghai Xuhui Central Hospital, 200031 Shanghai, China.
J Rehabil Med. 2021 May 18;53(5):jrm00191. doi: 10.2340/16501977-2836.
Recent clinical evidence supports that orthopaedic insoles, especially lateral-wedge insoles, can significantly benefit patients with knee osteoarthritis. The aim of this study is to explore the effects of orthopaedic insoles in patients with knee osteoarthritis.
Randomized controlled trials evaluating the effects of orthopaedic insoles on patients with knee osteoarthritis, published up to 16 February 2021, were reviewed and outcomes quantitatively summarized.
A total of 15 studies from 13 randomized controlled trials that involved 1,086 participants were included in this study. All the included studies exhibited a moderate bias risk and were of acceptable quality. The pooled mean difference of pain determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was -1.21 (p < 0.001, 95% confidence interval (95% CI) -2.61-0.18) with a high heterogeneity (I2 = 75%). In the sensitivity analysis, the overall incidence was -0.20 (p= 0.62, 95% CI= -0.87-0.46) with an accepted heterogeneity (I2 = 0%). No difference was observed between the Asian and Caucasian groups (p= 0.28). No significant difference was found in the pain score, Lequesne index or functional improvements.
Meta-analysis revealed that orthopaedic insoles do not provide relief of pain or improve functionality in patients with knee osteoarthritis.
最近的临床证据表明，矫形鞋垫，特别是外侧楔形鞋垫，能显著改善膝骨关节炎患者的病情。本研究旨在探讨矫形鞋垫对膝骨关节炎患者的影响。
对截至 2021 年 2 月 16 日发表的评估矫形鞋垫对膝骨关节炎患者影响的随机对照试验进行了回顾，并对结果进行了定量总结。
本研究共纳入了 13 项随机对照试验中的 15 项研究，共涉及 1086 名参与者。所有纳入的研究均存在中度偏倚风险，且质量尚可。采用西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评估的疼痛的 pooled mean difference 为-1.21（p<0.001，95%置信区间（95%CI）-2.61-0.18），存在高度异质性（I2=75%）。在敏感性分析中，总体发生率为-0.20（p=0.62，95%CI=-0.87-0.46），异质性可接受（I2=0%）。亚洲和高加索人群之间无差异（p=0.28）。疼痛评分、Lequesne 指数或功能改善方面均无显著差异。
荟萃分析显示，矫形鞋垫并不能缓解膝骨关节炎患者的疼痛或改善其功能。
