Several studies have shown that very specialized foot orthotics can
be helpful at reducing pain in patients who suffer from arthritis of the
knee. More specifically, these studies show that orthotics can help
patients with osteoarthritis of the medial compartment of the knee.
Foot Orthotics to Relieve Pain Associated with Knee Arthritis
The knee is made up of two compartments, the medial (closest to the
other leg) and lateral (outside of the leg) compartments. Studies have
shown that using custom orthotics with special valgus or lateral
wedges added to them can act to reduce pressure and pain in the medial
compartment of the knee.
We are experts at designing orthotics for patients with medial knee
osteoarthritis. Contact us today to make
an appointment for an evaluation in our Seattle foot and ankle clinic.
When do Foot Orthotics Work and when do they NOT Work in Reducing
Pain due to Knee Arthritis
Studies show that orthotics work best to reduce pain in cases of
arthritis affecting the medial (inside) knee. They do not help in every
case but overall can be quite effective at reducing pain. Some patients,
however, see no relief and a small number have increased pain and cannot
wear the orthotics. Orthotics for medial knee pain are extremely
specialized and standard foot orthotics can make medial knee pain worse.
Adjustments are often necessary to achieve best results. Be absolutely
certain that whoever makes your orthotics is a specialist in
biomechanics and orthotic therapy.
Orthotics are not effective at relieving knee pain in cases where
there is arthritis in both the lateral and medial compartment of the
knee. In fact, they may increase pain.
Orthotics may be helpful in some cases of lateral knee arthritis but
there have been no studies done that demonstrate this. Orthotics for
this problem would require a different type of wedging then those for
medial knee pain. Lateral osteoarthritis is less common than medial.
Although they may decrease pain, there is no evidence that orthoses
slow the progression of osteoarthritis of the knee
Your Appointment
If you have knee x-rays showing the extent of your arthritis, it would
be helpful to bring those with you to your appointment. If you do not
yet have xrays of your knees you many need to get them before orthotics
are made. If you have arthritis of both compartments of the knee, we
want to know that ahead of time as those patients may not tolerate foot
orthotics well.
Bring a pair of shorts or pants that you can roll up above the level
of your knee
We will likely perform an analysis of your gait (how you walk), your
foot function and your knee. Following the exam we will explain whether
it is likely that orthotics will help your knee pain.
Once you receive your orthotics, it may take several visits to wedge
the orthotics in a way that best decreases your pain.
If you have knee arthritis and have not yet had it evaluated by your
primary physician, orthopedist, rheumatologist or physiatrist, we will
refer you to the appropriate doctor. Orthotics can be a good tool for
helping reduce knee arthritis pain in some patients, but they are just
part of an overall treatment plan.
Normal Knee Medial Osteoarthritis
References: Foot Orthotics and Knee Arthritis
Butler RJ, Marchesi S, Royer T, Davis IS: The effect of a
subject-specific amount of lateral wedge on knee mechanics in patients
with medial knee osteoarthritis. J Orthop Res.2007 Sep;25(9):1121-7
Rubin R, Menz HB: Use of laterally wedged custom foot orthoses to
reduce pain associated with medial knee osteoarthritis: a preliminary
investigation. J Am Podiatr Med Assoc. 2005 Jul-Aug;95(4):347-352
Maillefert JF, Hudry C, Baron G, Kieffert P, Bourgeois P, Lechevalier
D, et al.Laterally elevated wedged insoles in the treatment of medial
compartment osteoarthritis: a prospective randomized controlled trial
Osteoarthritis and Cartilage / OARS Osteoarthritis ResearchSociety.
2001;
Pham T, Maillefert JF, Hudry C, Kieffert P, Lechevalier D, Dougados M.
Laterally elevated wedged insoles in the treatment of medial knee
osteoarthritis. Osteoarthritis and Cartilage 2004;12(1):4655.
McCulloch M.: The effect of foot orthotics and gait velocity on lower
limb kinematics and temporal events of stance. J Sports Phys Ther
17:2-10, 1993
McClay I: The evolution of the study of the mechanics of running.
Relationship to injury. J Am Podiatr Med Assoc Vol 90,133-148, 2000
Toda Y, Segal N, Kato A, Yamamoto S, Irie M. Effect of a novel insole
on the subtalar joint of patients with medial compartment osteoarthritis
of the knee. The Journal of Rheumatology 2001
.
Toda Y,TsukimuraN. A 2-year followup of a study to compare the
efficiency of lateral wedged insoles with subtalar strapping and in-shoe
lateral wedged insoles in patients with varus deformity osteoarthritis
of the knee. Osteoarthritis and Cartilage 2006;
Baker K, Goggins J, Xie H, Szumowski K, LaValleyM,Hunter D et al.A
randomized crossover trial of a wedged insole for treatment of knee
osteoarthritis. Arthritis and Rheumatism 2007
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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
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