Wednesday, November 28, 2012

Lateral Heel & Sole Wedges Improve OA KneePain

 I have been fabricating an orthotic (Clyde's OA Insert) since the mid-90's based on a 1993 article released by The Center for Hip and Knee Surgery in the Orthopaedic Review titled "Use of Lateral Heel and Sole Wedges in the Treatment of Medial Osteoarthritis on the Knee." The article confirmed two 1987 articles written  in Japan that reported success in using lateral heel wedges in the treatment medial osteoarthritis (OA).
  The physicians at The Center for Hip and Knee Surgery used a removeable shoe insert with 3/16" sole and 1/4" heel wedge. The orthotic could be moved from shoe to shoe. Their study was conducted between August 1987 and February 1989 on 121 knees. All patients were evaluated using the HSS knee scoring system prior to insertion of the wedge and on follow-up visits. The HSS (Hospital for Special Surgery) Pain Scoring System ia a method for evaluating knee pain.
  The result: 38% of the wedge wearers had little or no pain for an excellent result with 50% having a good result using the HSS scale for knee arthroplasty.
  Conclusion: Lateral heel and sole wedges may have a place in the conservative treatment of osteoarthritis of the knee.

  Now in August 2012 comes a biomechanical research study published in Gait & Posture from the United Kingdom that compares lateral wedge insoles and valgus braces for treatment of osteoarthritis (OA) of the knee.
  The UK study surprisingly indicated that adducting the knee mechanically from a external source (valgus brace) actually speeds the progression of knee OA. And that really the only significant clinical difference in patient outcomes was that the lateral-wedged insole had a greater amount of patient acceptance.
  Further the researchers concluded that the lateral wedges had a greater effect. Thus confirming the 1987 Japanese study and the 1993 article from The Center for Hip and Knee Surgery.

These results do not surprise me since I have had great success treating OA knee pain using a super thin and flexible composite insole for max stability and wedging it at the heel 1/4" and 3/16" at the sole.

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