Foot fashion could ease arthritic knees

The use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis, according to research presented at the American College of Rheumatology Annual Scientific Meeting.

“Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis,” said lead investigator, Dr Najia Shakoor, Associate Professor of medicine at Rush University in Chicago.

Dr Shakoor’s study showed  how the use of mobility shoes flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot, can affect knee osteoarthritis.

Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants noting a reduction in knee load that increased from 3.7% at the beginning of the study to 9.4% after six weeks, and to 18% at six months.

Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11%) even when wearing conventional shoes, leading researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with osteoarthritis walk.

“This study showed that specialised footwear was beneficial in reducing knee loads substantially over six months,” says Dr Shakoor.

“It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk even once the intervention is removed.”

Knee arthritis? Flexible options can help keep you active
Middle-aged men and women with osteoarthritis of the knee now have more options than ever before for treatments that may allow them to remain active in the sports they love, according to a review published in an issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

“The number of patients between the ages of 40 and 60 who are experiencing knee arthritis is growing, and unlike most older patients, this patient population presents a unique set of treatment challenges,” noted lead author, Dr Brian Feeley, Assistant Professor of orthopaedic surgery, University of California, San Francisco.

“Understanding available options and tailoring treatments to each patient’s needs and desires is the key to successful outcomes.”

The review examined both surgical and non-surgical treatments available for younger patients with knee arthritis, to determine the best course of action for patients who want to continue to participate in demanding sports.

Unlike elderly patients, where pain reduction and basic mobility are the two primary goals, Dr Feeley noted younger, more active patients require more flexible treatment programs to allow them to remain as active as they would like.

“There is an increasing trend in the United States of people who want to stay active in sports and recreational activities after the age of 40. These patients are not content with being told to stop what they love doing,” added Dr Feeley.

“As a result, orthopaedic surgeons and other physicians need to come up with different treatment strategies including non-operative treatments or even cartilage restoration procedures, to address pain and functionality, and to help keep patients as active as possible.

“In a vast majority of cases, the onset of arthritis is a slow, degenerative process and therefore there is rarely a need to rush to surgery,” he added.

“Depending on the symptoms and activity level, many patients can be managed well with non-operative treatment strategies, whereas others truly benefit from surgical procedures. For each patient, it is important to tailor treatment to their symptoms and activity level, and to look for a healthcare provider who is willing to work with them over time to keep their knee as healthy as possible.”

Although alternative treatments like acupuncture, glucosamine and chondroitin may be incorporated into an overall treatment plan, Dr Feeley noted that currently there is no strong clinical evidence supporting the efficacy of these alternative-types of treatment.