Grant: CIHR Fellowship

Osteoarthritis (OA) is the most common disease affecting the muscular and skeletal system. It causes pain and disability in nearly 5 million Canadians and costs the Canadian health care system over $10 billion annually. There is no cure and with our ageing population, these number will only continue to grow. Conservative treatments (non-surgical and non-pharmacological) such as exercise or shoe-worn insoles can improve pain, function, and potentially slow disease progression. Therefore, they remain the most recommended treatment for patients with OA in joints such as the knee. However, the success of these treatments can be quite varied between patients, as some patients respond very well and others respond poorly. The research conducted by Dr. Kobsar during his PhD was the first to discover that it is possible to identify individual patients more likely to respond to a given treatment prior to beginning it. Similarly, Dr. Hunt has recently identified a shoe-worn insole that may be an effective treatment for many people with knee OA. Therefore the proposed project is the logical extension and combination of Dr. Kobsar and Dr. Hunt's recent work. Specifically, the primary purpose of the study is to determine the effect of a shoe-worn insole on pain, function, and knee mechanics in patients with knee OA. A total of 102 knee OA patients will be randomly given either a customized insole or a standard insole (control group) to wear for a period of 9 months. The results of this study will determine the effect of a customized insole on pain, function, and knee mechanics. The study will also examine the characteristics of these knee OA patients in relation to their response in order to predict and prescribe this treatment to future individuals who are most likely to respond favourably. Identifying inexpensive methods, such as insoles, and prescription guidelines can provide a safe and effective way to reduce the substantial personal and economic burdens associated with OA.