Guideline for the management of knee and hip osteoarthritis

Recommendations

Braces, orthotics, taping, footwear and canes

Non-pharmacological interventions 

Braces, orthotics, taping, footwear and canes


 

Intervention: Knee braces

Recommendation

We are unable to recommend either for or against the use of varus unloading/realignment braces for people with lateral tibiofemoral compartment knee osteoarthritis (OA). 

Strength of recommendation

Conditional (neutral) recommendation
(varus unloading/ realignment braces)

Quality of evidence

Very low
(varus unloading/ realignment – no randomised controlled trial [RCT] data)

Recommendation

We suggest not offering valgus unloading/realignment braces for people with medial tibiofemoral compartment knee OA.

Strength of recommendation

Conditional against recommendation
(valgus unloading/ realignment braces)

Quality of evidence

Low
(valgus unloading/ realignment braces)

Recommendation

We suggest not offering realigning patellofemoral braces for patellofemoral OA.

Strength of recommendation

Conditional against recommendation
(realigning patellofemoral braces)

Quality of evidence

Very low
(realigning patellofemoral braces)

Intervention: Shoe orthotics (medial and lateral wedge insoles – knee, shock-absorbing insoles and arch supports – knee and/or hip)

Recommendation

We are unable to recommend either for or against the use of medial wedged insoles for people with lateral tibiofemoral OA and valgus deformity.

Strength of recommendation

Conditional (neutral) recommendation  
(medial wedge insoles for lateral tibiofemoral OA)

Quality of evidence

Very low
(medial lateral wedged insoles)

Recommendation

We suggest not offering lateral wedge insoles for people with medial tibiofemoral knee OA.

Strength of recommendation

Conditional against recommendation  
(lateral wedge insoles)

Quality of evidence

Very low
(medial lateral wedged insoles)

Recommendation

We are unable to recommend either for or against the use of shock-absorbing insoles or arch supports for knee and/or hip OA.

Strength of recommendation

Conditional (neutral) recommendation  
(shock-absorbing insoles, arch supports)

Quality of evidence

Very low
(shockabsorbing insoles,  arch support –  no RCT data)

Very low  
(all hip orthotics –  no RCT data)

Intervention: Footwear – Knee

Recommendation

We suggest not offering unloading shoes, minimalist footwear or rocker-sole shoes for people with symptomatic knee OA. However, clinicians may consider advising people to wear footwear with shock-absorbing properties and avoid high-heeled shoes.

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low
(unloading shoes, minimalist footwear)

Low  (rocker-sole shoes)

Intervention: Taping – knee and/or hip

Recommendation

We are unable to recommend either for or against the use of patellar taping for people with knee OA.

Strength of recommendation

Conditional (neutral) recommendation
(patellar taping)

Quality of evidence

Very low

Recommendation

We suggest not offering kinesio taping for people with knee and/or hip OA.

Strength of recommendation

Conditional against recommendation
(kinesio taping)

Quality of evidence

Intervention: Assistive walking device – Knee and/ or hip

Recommendation

It may be appropriate to offer an assistive walking device (eg cane) for some people with knee and/or hip OA, depending on a person’s preference  and capability.

Strength of recommendation

Conditional for recommendation

Quality of evidence

Low (knee)

Very low (hip

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