Conventional walking shoes are about as effective as unloading shoes for improving pain and function in knee osteoarthritis. Results of a randomized, controlled trial are published in Annals of Internal Medicine.

Osteoarthritis of the knee results in pain, physical dysfunction, and reduced quality of life, and is one of the most common reasons for older people to see a doctor. Since there is no cure, self-management is the cornerstone of conservative treatment, along with exercise and weight control. Clinical guidelines for knee osteoarthritis recommend appropriate footwear as part of core treatment, which may include conventional walking shoes or unloading shoes. Unloading shoes have modified, stiffer soles designed to reposition the foot and reduce load to the knee. Currently, there is little evidence to determine which type of shoe is the better choice for relieving symptoms.

Researchers randomly assigned 160 persons with medial knee osteoarthritis to wear either unloading shoes (intervention) or conventional walking shoes (comparator) daily for 6 months. At 6 months, both groups were assessed for pain with walking and physical function, among other secondary measures of improvement. They found that changes in pain and function did not differ between the intervention and comparator groups, with both showing improvements that generally were clinically relevant.

The authors of an accompanying editorial point out that the patients in both treatment groups received new shoes to wear during the trial period. They write, "It has been said that 'Cinderella is proof that a new pair of shoes can change your life.' Wouldn't it be wonderful if a simple pair of new shoes could help your patients with knee osteoarthritis?"

Article: Unloading Shoes for Self-Management of Knee Osteoarthritis: A Randomized Trial , Rana S. Hinman, BPhysio(Hons), PhD; Tim V. Wrigley, BSc(Hons), MSc; Ben R. Metcalf, BSc(Hons); Penny K. Campbell, BAppSci(FoodSci&Nutr); Kade L. Paterson, BAppSci(Hons), BPod, PhD; David J. Hunter, MBBS, PhD; Jessica Kasza, BSc(Hons), PhD; Andrew Forbes, BSc(Hons), MS, PhD; and Kim L. Bennell, BAppSci(Physio), PhD, Annals of Internal Medicine, doi:10.7326/M16-0453, published online 12 July 2016.

Editorial: A Cinderella Tale: Can New Shoes Change the Life of a Person With Knee Osteoarthritis? Marian T. Hannan, DSc, MPH; Carol A. Oatis, PhD, PT; and Robert R. McLean, DSc, MPH, Annals of Internal Medicine, doi:10.7326/M16-1459, published online 12 July 2016.