The Effect of Biomechanical Footwear on Pain from Knee Osteoarthritis

Document Type : CURRENT CONCEPTS REVIEW

Authors

1 Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

2 Department of Physical Medicine and Rehabilitation, “La Paz” University Hospital-IdiPaz, Madrid, Spain

3 Department of Physical Medicine and Rehabilitation, “Cruz Roja San José and Santa Adela” University Hospital, Madrid, Spain

Abstract

The effect of biomechanical footwear on pain from knee osteoarthritis (OA) is still unclear and controversial. The 
purpose of this article is to review the literature with the aim of answering the following question: What is the impact 
of biomechanical footwear on pain from knee OA? A Cochrane Library and PubMed (MEDLINE) search related to 
the effect of biomechanical footwear on pain from knee OA was performed. Several authors have reported knee pain 
alleviation in people with knee OA using biomechanical footwear. However, many of them have also stated that further 
investigation was required to evaluate its long-run effectiveness and safety, as well as replication, prior to reaching 
conclusions about the clinical value of this treatment. The cost of biomechanical footwear treatment is around 5,000 US 
dollars. Considering the weak evidence currently available on the efficacy of biomechanical footwear and its high cost, 
we do not advise the routine use of that treatment until it can be unequivocally confirmed that it is truly effective for pain 
alleviation in patients with knee OA.
Level of evidence: III

Keywords


  1. Collaborators GB. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.
  2. Gore M, Tai K-S, Sadosky A, Leslie D, Stacey BR. Use and costs of prescription medications and alternative treatments in patients with osteoarthritis and chronic low back pain in community-based settings. Pain Pract. 2012;12(7):550-560.
  3. da Costa BR, Nüesch E, Kasteler R, Husni E, Welch V, Rutjes AWS, et al. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev 2014 ;(9):CD003115.
  4. da Costa BR, Reichenbach S, Keller N, Nartey L, Wandel S, Jüni P, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis. Lancet. 2017;390(10090):e21-e33.
  5. Trelle S, Reichenbach S,Wandel S, Hildebrand P, Tschannen B, Villiger PM, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs. BMJ. 2011;342:c7086.
  6. Baigent C. Coxib and traditional NSAID Trialists’(CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382:769-9.
  7. McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22(3):363-388.
  8. Parkes MJ, Maricar N, Lunt M, LaValley MP, Jones RK, Segal NA, et al. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis. JAMA. 2013;310(7):722-730.
  9. Hinman RS, Wrigley TV, Metcalf BR, Campbell PK, Paterson KL, Hunter DJ, et al. Unloading shoes for self-management of knee osteoarthritis. Ann Intern Med. 2016;165(6):381-389.
  10. Bar-ZiV Y, Beer Y, Ran Y, Benedict S, Halperin N. A treatment applying a biomechanical device to the feet of patients with knee osteoarthritis results in reduced pain and improved function: a prospective controlled study. BMC Musculoskeletal Disorders. 2010;11(1):1-8.
  11. apostherapy.com (Treatment plan and Pricing AposTherapy® (accessed 8 December 2020).
  12. Roos EM, Klassbo M, Lohmander LS. WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Scan J Rheumatol 1999;28:210-215.
  13. McCarthy CJ, Oldham JA. The reliability, validity responsiveness of an Aggregated Locomotor Function (ALF) score in patients with osteoarthritis of the knee. Rheumatology 2004;43(4):514-517.
  14. Drexler M, Elbaz A, Mor A, Debi R, Debbi EM, Haim A, et al. Effects of a customized biomechanical therapy on patients with medial compartment knee osteoarthritis. Ann Phys Rehabil Med 2012;55(4):213-228.
  15. Reichenbach S, Felson DT, Hincapié CA, Heldner S, Bütikofer L, Lenz A, et al. Effect of biomechanical footwear on knee pain in people with knee osteoarthritis. The BIOTOK randomized clinical trial. JAMA. 2020;323(18):1802-1812.
  16. Bar-Ziv Y, Debbi EM, Ran Y, Benedict S, Halperin N, Beer Y. Long-term effects of AposTherapy in patients with osteoarthritis of the knee: A two-year followup. Arthritis 2013;2013:689236
  17. Elbaz A, Mor A, Segal G, Aloni Y, Teo YH, Teo YS, et al. Patients with knee osteoarthritis demonstrate improved gait pattern and reduced pain following a non-invasive biomechanical therapy: A prospective multi-centre study on Singaporean population. J Orthop Surg Res. 2014;9(1):1-8.
  18. Miles C, Greene A. The effect of treatment with a non-invasive foot worn biomechanical device on subjective and objective measures in patients with knee osteoarthritis- a retrospective analysis on a UK population. BMC Musculoskeletal Disorders 2020;21(1):386.