Can Foot Orthoses Have An Impact For Knee Osteoarthritis?
Dr. Kevin Kirby, DPM Given the common nature of knee
Patient
Female, 62 years old, 165 lbs.
Complaints
Pain at the 1st metatarsal head bilaterally and pain and numbness in the 3rd interdigital space, right foot.
History
Four years ago patient was treated with prescription orthotics. They were posted with four degrees rearfoot posts, additions were metatarsal pads and Morton’s extension bilaterally.
Examination Findings
Bilateral hallux abducto valgus deformities R>L. Mulitple digital contractures. Short first metatarsals bilaterally. Rearfoot varus four degrees bilaterally. Hypermobile first metatarsal segments bilaterally. Hyperkeratonic lesions sub-second metatarsals bilaterally.
Diagnosis
Patient has an obvious Morton’s type foot deformity. Because the patient’s forefoot was not treated in such a way as to prevent further deformity her condition has gotten progressively worse over the last four years. .
Treatment
Flexible orthotics with a narrow grind, four degree rearfoot varus posts, 2-5 1/8″ bar with a 1st met cut out, bilateral. After a two week break-in period of wearing the orthotics a digital orthoses was fabricated and subsequently after a one-week trial the opposite digital orthoses was fabricated and dispensed. Patient was instructed to return in two months for final check up.
Follow up
After two months the patient reported a marked improvement of all of her symptoms. She was told that the digital orthoses would probably have to be replaced within a year due to digital straightening. After that, replacement is about every two years. These guidelines will vary with each patient.
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