This is a study I could have done in my youth. I was tasked by our orthopedic team to valgus wedge patients with medial knee compartment disease. I would say that the wedging alone worked 50% of the time at opening up the medial knee joint space and reducing pain. When I added custom orthotic devices in the pronators of this group, along with the best valgus wedging allowed by their mechanics, the success was now in the 90s. Therefore, when treating a patient for medial knee osteoarthritis, I could successfully help 90% of them, with the others going to knee replacements a little sooner than they wanted.
This study gave both types of inserts: 1) 5 degree lateral wedging and 2) 5 degree lateral wedging under a custom orthotic device. There is no discussion into how they individualized the orthotic devices. In fact, most research projects give their participants everything equal, whether their biomechanics need that or not. Still, after 2 months of the wedge only and 2 months of the orthotic/wedge combination, most of the 24 participants had improved pain, improved function, and preferred using the combination or the wedge alone.
