This work examined the evidence base concerning the efficacy of laterally wedged foot orthotics for improving the symptomatology associated with painful disabling osteoarthritis of the knee medial compartment. To this end, all relevant peer-reviewed publications on this topic published in the English language were retrieved and analysed. In addition, related biomechanical publications were analysed. These data indicate a strong scientific basis for applying wedged insoles in attempts to reduce osteoarthritic pain of biomechanical origin. Further research to substantiate their efficacy in well-designed clinical trials seems warranted.