A Multi-centre Study of Shoe-worn Insoles and Knee Osteoarthritis

Inclusion Criteria: * medial tibiofemoral OA defined as definitive osteophytes and joint space narrowing in the medial compartment, as confirmed with radiographs * history of knee pain longer than 6 months * average self-reported knee pain of at least 3 out of 10 (using an 11-point numerical rating scale with terminal descriptors of 0 = "no pain" and 10 = "worst pain imaginable") over the 6 months prior to baseline testing * pain in the same foot/feet as the painful knee(s) * ability to communicate in English * show an immediate biomechanical response to the insoles. This final eligibility criterion will be determined from an in-person biomechanical assessment after participants have passed all previous eligibility screening. Exclusion Criteria: * radiographic evidence of more lateral tibiofemoral OA than medial * knee surgery or intra-articular injection within the previous 6 months * current or recent (within 6 months) corticosteroid use for any reason * presence of a systemic arthritic condition * history of knee joint replacement or tibial osteotomy * any other condition affecting lower limb function * current usage of shoe-worn insoles, or planning to acquire footwear modifications in the next 6 months * any previous experience with insoles that resulted in increased lower limb pain or a self- or clinician-initiated termination of use.