Obesity and Foot Surgery
A new study published in Orthopedic Clinics of North America has reviewed the evidence addressing obesity and elective foot and ankle surgery.
This research states that obese patients have higher rates of foot and ankle pain, probably due to increased biomechanical loading on joints, adjustments in gait and metabolic effects of excess adipose tissue. However, they highlight that the evidence for complications following total ankle replacements and foot surgery in obese patients is still conflicting and needs further research.
The study concludes that it is vital to advise obese patients about weight loss and to educate them about conditions which are attributed to carrying too much weight prior to elective surgical intervention.
Foot orthoses -v- Gait Retraining
A pilot RCT, published in Journal of Science and Medicine in Sport has looked at gait retraining versus foot orthoses for patellofemoral pain.
This RCT was performed in order to determine the feasibility of a full clinical trial. Sixteen runners were allocated to either a 6 week gait retraining intervention (increasing cadence and use of a minimalist shoe) or prefabricated foot orthoses alone.
The results of this small study suggest that a 6 week gait retraining program may be clinically meaningful for runners with patellofemoral pain compared to prefabricated foot orthoses. A larger clinical trial is now needed.
Effects of medially and laterally wedged orthoses
A small study published in Physical Therapy in Sport has examined the mechanical effects of medial and lateral wedged orthoses during running.
12 runners were asked to run over a force platform with either medially posted or laterally posted orthoses or no orthoses at all. Lower limb kinematics were collected using a camera motion capture system and differences in knee joint kinetics between the different orthotic conditions were examined.
The study concluded that medially and laterally wedged orthoses significantly increase patellofemoral loading which could increase risk of patellofemoral pain. However they also state that laterally wedged orthoses significantly reduce the knee adduction moment suggesting that this may reduce the risk of medial tibiofemoral compartment OA in runners.