# Exploring the Potential of Lateral Wedge Insoles in Alleviating Bone Marrow Lesions in End-Stage Knee Osteoarthritis: A Preliminary Case Report

## TL;DR

This case report suggests that lateral wedge insoles may help reduce bone marrow lesions in a patient with severe knee osteoarthritis.

## Contribution

Preliminary evidence is provided on the potential benefits of lateral wedge insoles for end-stage knee osteoarthritis.

## Key findings

- Bone marrow lesion grade decreased from 2 to 1 after 12 months of using lateral wedge insoles.
- Lower co-contraction ratios in knee muscles were observed after 12 months of insole use.

## Abstract

The efficacy of lateral wedge insoles (LWIs) in patients with end-stage knee osteoarthritis (OA) is unclear.

A 43-year-old male underwent two anterior cruciate ligament reconstructions in his right knee and was later diagnosed with end-stage knee OA. An LWI combining arch support with a lateral heel wedge was fabricated for this patient and used over 12 months. As a result, after 12 months, the bone marrow lesion (BML), as measured by the magnetic resonance imaging Osteoarthritis Knee Score (MOAKS), was downgraded from grade 2 to grade 1.

The use of LWI in a patient with end-stage knee OA showed lower co-contraction ratios in knee muscles even after 12 months. The results provide preliminary evidence suggesting the use of LWI in patients with end-stage knee OA has potential benefits for reducing BML.