Can Foot Orthoses Have An Impact For Knee Osteoarthritis?
Dr. Kevin Kirby, DPM Given the common nature of knee
Patient
Female, 35 years old, 135 lbs
Complaint
Throbbing pain sub-second and third metatarsal of the right foot.
History
The patient was treated by another podiatrist and prescription orthotics were made. Although the orthotics were comfortable, the pain is still present and getting worse.
Clinical Observations
Moderate hallux abducto valgus deformity bilateral, right greater than the left. The first metatarsal on examination is hypermobile and short in relation to the second metatarsal.
A mildly diffuse callus is present sub-second and third metatarsal right foot. The patients second and third toes were severely contracted and beginning to fuse at the proximal interphalangeal joints. Compensated rearfoot varus deformity 4 deg bilaterally.
Diagnosis
- Compensated rearfoot varus
- Short and hypermobile first metatarsal
- Multiple lesser digital contractions
- Moderate HAV deformity
Orthotic Management
Upon examination of the previously prescribed orthotics, the othotics had a perpendicular rearfoot post.
- Increase the rearfoot post to 4 deg to match her foot.
- Add 1/8″ metatarsal bar with a 1st met head cut out
- Fabricate digital orthosis bilaterally
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