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Lateral foot wedging for medial knee OA

Discussion in 'Biomechanics, Sports and Foot orthoses' started by admin, Aug 13, 2005.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles?: An ancillary analysis from the SILK trial
    Dr Graham J. Chapman, PhD, Matthew J. Parkes, BSc, Laura Forsythe, BSc, David T. Felson, MD, MPH, Richard K. Jones, PhD
    Osteoarthritis and Cartilage; Article in Press
     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Prospective study on the effects of orthotic treatment for medial knee osteoarthritis in Chinese patients: clinical outcome and gait analysis.
    Fu HC, Lie CW, Ng TP, Chen KW, Tse CY, Wong WH
    Hong Kong Med J. 2015 Mar 10
     
  3. drhunt1

    drhunt1 Well-Known Member

    Re: the varus deformity of medial compartment osteoarthritis

    Looks like Kathleen was right....and she was mocked by several contributors here. First, that doesn't surprise me, and second...a lot of people are going to, again, have egg on their faces before long.
     
  4. efuller

    efuller MVP

    Re: the varus deformity of medial compartment osteoarthritis

    Matt,
    Your post is rather inflammatory. If you want to reopen a five year old discussion you should discuss the merits of the argument and not "mock" the people who made the argument.

    So, why do you think Kathleen was right?

    Eric
     
  5. drhunt1

    drhunt1 Well-Known Member

    Re: the varus deformity of medial compartment osteoarthritis

    Sorry if my post appears that way...but it pales in comparison to the several posters that responded to Kathleen Reilly. The problem is the dogmatic style and attitude many here adhere. It "locks one into a position", that cannot be refuted, denied and/or extrapolated from. Once a person no longer is able to step back, take a deep breath, admit they were probably wrong and then move forward under a newer way of treating patients, then perhaps they should consider retirement. Like I've written before, we ALL should be finding ourselves in a position to continue to learn. Our patients are a treasure trove of information....same with other practitioners that bring a fresh viewpoint to "the game".

    The answer to this riddle has already been discussed, in various forms and forums, previously. No one, however, has put the final touches on it and solidified/coalesced the information in a more palatable manner. I intend to do just that....if for no other reason than to prove I'm not a "one-trick pony". :D Cheers.
     
  6. efuller

    efuller MVP

    Re: the varus deformity of medial compartment osteoarthritis

    After a quick look I did not see any posts that mocked her. I saw people disagreeing respectfully. I certainly did not see anything that would make your post pale in comparison.



    Yes, everyone should be able to change there mind in light of a well reasoned, well substantiated argument.

    Eric
     
  7. drhunt1

    drhunt1 Well-Known Member

    Re: the varus deformity of medial compartment osteoarthritis

    I suggest you read post #21 again. Suffice it to write that the "dogma dogs" here did not show, IMO, Kathleen the respect she deserved. How she came about this site is pure conjecture...perhaps a Google search led her to this site. But she didn't last long, obviously, especially after the gurus continued with their adherence to the valgus wedging diatribe...which is precisely what it is. More on this later.

    I am reminded of a story about my experience at CCPM...bear with me. I tested out of Biochemistry my first year up there. Mary Mazotta(sp?) informed me that I was only responsible for two lectures given by an MD/PhD from UCSF whom lectured on cholesterol...boy did he ever! He informed the class that ALL exogenous forms of cholesterol had to be eliminated or reduced in human diets. That means pork, beef, cheese, milk, lamb etc had to be limited in intake and consumption. I scoffed at this idea but kept it to myself. His suggestions flew in the face of biochemistry precepts and pathways, but on and on he ranted.

    It wasn't until years later that Dr. Atkins proved him wrong, and me right. Moral of the story? Don't be so locked in to your own belief system that you can't learn from your mistakes. The Orthos are flat wrong about valgus wedging...because their fundamental knowledge of LE biomechanics is lacking. Hope this helps.
     
  8. efuller

    efuller MVP

    Re: the varus deformity of medial compartment osteoarthritis

    Matt, that was a reasoned disagreement. The poster took quotes and explained why he disagreed with them. Your post was more inflammatory than that.

    You just called everyone a jerk and then implied that they were wrong and that people are going to look stupid and you will explain why later. You could have just skipped the insult and gone right to the debate.

    Eric
     
  9. drhunt1

    drhunt1 Well-Known Member

    Re: the varus deformity of medial compartment osteoarthritis

    Eric-I expected that response from you. Payne's "disagreement" with Kathleen was "slightly" more than reasoned. Further, I never called anyone a jerk...did I? And when did I ever write that posters here would look stupid? Is "egg on their faces" the same in your world? It appears to this observer, that you too have a lot invested in this topic. Do you adhere to the lateral wedge extension for resolution of medial knee pain? Don't be so quick to jump on the latest "flavor of the month" bandwagon...and go back and determine normal foot function. Once one understands normal, than variations can lead you to the process of discovery...in this case, medial knee DJD, (notice I'm not referring to it as OA). Good luck.
     
  10. efuller

    efuller MVP

    Re: the varus deformity of medial compartment osteoarthritis

    Ok Matt, you said that posters "mocked" her behavior. I saw disagreement. Could you point out what you thought was mocking? Also when you said that you were not surprised by the mocking, one would think, that you think, that mocking behavior is done by jerks. What was your purpose in pointing out the alleged mocking?

    Matt, do you know the logic behind the argument for lateral foot wedging for medial knee osteoarthritis? If you do, could you point out the flaw(s) in that argument?

    Matt, can you tell me how normal foot function was determined. Why should we accept any single particular "function" as normal? It appears that you are still on the "normal" foot function bandwagon, when that approach has been correctly abandoned by many long ago.

    Still waiting for you to discuss the pros and cons of lateral foot wedging.

    Eric
     
  11. drhunt1

    drhunt1 Well-Known Member

    Re: the varus deformity of medial compartment osteoarthritis

    That approach has been abandoned? Perhaps that's their, (your) problem. Why should I discuss with you here on a public forum, research that I'm currently undertaking to produce a meaningful, prudent and extraordinarily precise article on the topic. Are you wanting me to "spill the beans" before they are cooked? Why would I do that for you, Eric? BTW...my article on GP's in children and RLS in adults is slated for national publication next month...just a few weeks away. Funny how I've been able to resolve long standing problems with an approach you feel was correctly abandoned long ago.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Immediate and long-term efficacy of laterally-wedged insoles on persons with bilateral medial knee osteoarthritis during walking.
    Hsu WC, Jhong YC, Chen HL, Lin YJ, Chen LF, Hsieh LF
    Biomed Eng Online. 2015 May 14;14(1):43. doi: 10.1186/s12938-015-0040-6.
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: A randomised trial
    Richard K Jones, Graham J Chapman, Matthew J Parkes, Laura Forsythe andDavid T Felson
    Journal of Orthopaedic Research; Accepted Article
     
  15. Just yesterday I sent in my completed feature article on the biomechanics and application of valgus wedged insoles/orthotics for medial knee osteoarthritis that will be published in the October 2015 issue of Podiatry Today magazine titled, "Can Foot Orthoses Have An Impact For Knee Osteoarthritis?" In my research on this article (75 references), I found some very interesting scientific studies on this subject. I think most podiatrists and other foot-health clinicians should find the article very interesting.
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effect of exercise therapy on knee adduction moment in individuals with knee osteoarthritis: A systematic review
    Giovanni E. Ferreira, Caroline Cabral Robinson, Matheus Wiebusch, Carolina Cabral de Mello Viero, Luis Henrique Telles da Rosa, Marcelo Faria Silva
    Clinical Biomechanics; July 2015Volume 30, Issue 6, Pages 521–527
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lateral wedge insole for knee osteoarthritis: randomized clinical trial.
    Campos GC et al
    Sao Paulo Med J. 2015 Feb;133(1):13-9. doi: 10.1590/1516-3180.2013.6750002. Epub 2014 Oct 17.
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lateral wedge insoles for reducing biomechanical risk factors for medial knee osteoarthritis progression: A systematic review and meta-analysis
    John B. Arnold, Daniel X. Wong, Richard K. Jones, Catherine L. Hill and Dominic Thewlis
    Arthritis Care & Research;
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A general scheme to reduce the knee adduction moment by modifying a combination of gait variables.
    Favre J, Erhart-Hledik JC, Chehab EF, Andriacchi TP.
    J Orthop Res. 2016 Jan 7. doi: 10.1002/jor.23151
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet
    Gillian L. Hatfield et al
    Journal of Orthopaedic Research; Accepted Article
     
  21. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Immediate and One Week Effects of Laterally Wedge Insoles on Gait Biomechanics in Healthy Females
    Joshua T. Weinhandl, Sarah E. Sudheimer, Bonnie L. Van Lunen, Kimberly Stewart, Matthew C. Hoch
    Gait and Posture; Article in Press
     
  22. drhunt1

    drhunt1 Well-Known Member

    Interesting short term study...with ramifications that, indeed, transcend any immediate relief. The number of Americans that are undergoing prosthetic knee replacement surgery is increasing at an exponential rate, and in 2010 alone, 720K knees were replaced at a cost of approx. $10B. Factor in the arthroscopic "cleanup procedures" that take place prior to the prosthetic surgery, and one can begin to appreciate the need for better early detection with preventative actions. The only benefit I can ascertain from the recent plethora of research/articles published on lateral wedging of orthotics is that at least people are beginning to recognize the effect of the foot on the knee. IMO, however, they have the solution exactly backwards. Hope this helps.
     
  23. efuller

    efuller MVP

    It was interesting that the study was done with normally aligned knees. The benefit from increased external abduction moment theory would predict that the wedges would be helpful for those with genu varum and harmful for those with genu valgum.

    Matt, why do you think that the solution is backwards?

    Eric
     
  24. drhunt1

    drhunt1 Well-Known Member

    Eric-if you read my article, therein resides multiple clues. Check out the two pics I had placed in it....their solution is backwards.
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effect of orthotic devices on knee adduction moment, pain and function in medial compartment knee osteoarthritis: a literature review.
    Baghaei Roodsari R et al
    Disabil Rehabil Assist Technol. 2016 Mar 15:1-9
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Prediction of knee joint moment changes during walking in response to wedged insole interventions.
    Lewinson RT, Stefanyshyn DJ
    Proc Inst Mech Eng H. 2016 Apr;230(4):335-42
     
  27. drhunt1

    drhunt1 Well-Known Member

    What...no placebo orthotic? Some of the Aussie Pods must be squirming. Still...while I don't have access to the entire article, it appears some of the investigators are getting closer to the truth.
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Calculation of external knee adduction moments: a comparison of an inverse dynamics approach and a simplified lever-arm approach.
    Lewinson RT, Worobets JT, Stefanyshyn DJ
    Knee. 2015 Sep;22(4):292-7.
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles?: an ancillary analysis from the SILK trial.
    Chapman GJ e al
    Osteoarthritis Cartilage. 2015 Aug;23(8):1316-22
     
  30. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Important findings: " 33% increased their EKAM and 67% decreased their EKAM" ...ie subject specific responses by: "Ankle angle at peak EKAM and peak eversion ankle/STJ complex angle in the control condition predicted if individuals were likely to decrease EKAM under lateral wedge conditions"

    my "gut" experiences in the RCT I was involved in was that there was more likely to be a response in those with limited eversion.
     
  31. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee.
    Cherian JJ et al
    Bone Joint J. 2016 Jan;98-B(1 Suppl A):89-94
     
  32. Trevor Prior

    Trevor Prior Active Member

    Craig

    With the work I have done with the 3D analysis, accepting we are not measuring joint moments, I have observed in a couple of patients (low numbers also accepted) that they have high tibial rotation.

    Given some of the work from Chris Nester and his team indicating that tibial rotation may couple with arch height, I reviewed navicular drop / drift and found increased motion.

    Logically, my thought process was along the lines of increased tibial rotation has the potential to increase load through an arthritic knee and thus provided a simple orthosis to control arch and thus, hopefully, tibial rotation. I did not have the opportunity to re-test with the 3d but when I have tested orthoses, these regularly reduce tibial rotation.

    A simple squat test revealed an 80% reduction in symptoms and the patient reported the benefit on review at 8 weeks.

    Thus, this indicates there is more than one mechanism for exacerbating symptoms with knee OA and may explain some of the variability in the response to lateral wedges. Indeed, I suspect many pathologies we see have more than one mechanism of injury in terms of loading patterns.

    I will be discussing this and tibial rotation during mt talk at BSS this year.

    Out of interest, are we able to measure rotation forces in a similar manner to ab/adduction moments?

    Trevor
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment.
    Tokunaga K et al
    J Appl Biomech. 2016 Jun 1
     
  34. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Clinical effects of lateral wedge arch support insoles in knee osteoarthritis: A prospective double-blind randomized study.
    Hsieh RL, Lee WC.
    Medicine (Baltimore). 2016 Jul;95(27):e3952
     
  35. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Wedged Insoles and Gait in Patients with Knee Osteoarthritis: A Biomechanical Review
    Ryan T. Lewinson, Darren J. Stefanyshyn
    Lewinson, R.T. & Stefanyshyn, D.J.
    Ann Biomed Eng (2016). doi:10.1007/s10439-016-
     
  36. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effects of two different degrees of lateral-wedge insoles on unilateral lower extremity load-bearing line in patients with medial knee osteoarthritis.
    Yılmaz B et al
    Acta Orthop Traumatol Turc. 2016 Jul 21
     
  37. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Gait Retraining with real-time Biofeedback to reduce Knee adduction moment: systematic review of effects and methods used
    Rosie. Richards, MS, Josien. C. van den Noort, PhD, Joost. Dekker, PhD, Jaap. Harlaar, PhD
    Arch Phys Med Rehab; Article in Press
     
  38. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Foot alignments influence the effect of knee adduction moment with lateral wedge insoles during gait
    Tomonori Sawada, Kazuki Tokuda, Kenji Tanimoto, Yo****aka Iwamoto, Yuta Ogata, Masaya Anan, Makoto Takahashi, Nobuhiro Kito, Koichi Shinkoda
    Gait and Posture; Article in Press
     
  39. NewsBot

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    Articles:
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    Effects of foot orthoses with medial arch support and lateral wedge on knee adduction moment in patients with medial knee osteoarthritis
    Yoann Dessery et al
    Prosthet Orthot Int August 23, 2016
     
  40. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Reduced knee adduction moments for management of knee osteoarthritis: a three month phase I/II randomized controlled trial
    Ryan T. Lewinson et al
    Gait and Posture; Article in Press
     
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