nach oben

Clinical Rheumatology

Erschienen in:

01.11.2014 | Review Article

The effect of lateral wedge insoles in patients with medial compartment knee osteoarthritis: balancing biomechanics with pain neuroscience

verfasst von: Isabel A. C. Baert, Jo Nijs, Mira Meeus, Enrique Lluch, Filip Struyf

Erschienen in: Clinical Rheumatology | Ausgabe 11/2014

Einloggen, um Zugang zu erhalten

Abstract

Results on the effects of lateral wedge insoles (LWIs) in patients with medial knee osteoarthritis (OA) are ambiguous and not fully understood. Because of the low cost of this intervention and its clinical utility, attention to LWIs is worth considering. Current insights on the efficacy of LWIs are mainly focused on changing biomechanical aspects, such as the external knee adduction moment, in an attempt to influence pain, functional ability and structural progression. It is however appropriate to interpret the effectiveness of LWIs in a broader concept than the pure biomechanical approach. Given our current understanding of OA-related pain, including the involvement of the central nervous system and nociception–motor interactions, concepts of pain neuroscience should be taken into account. The purpose of this review is to summarize the current state of knowledge regarding the biomechanical effect of LWIs. It aims to discuss the degree to which such biomechanical effect translates to clinical effects (symptom relief, function recovery and reduction of structural progression). In order to explain these clinical effects, this paper balances biomechanics with pain neuroscience. A literature search was performed and reviewed using a narrative approach. Many studies investigated the effect of LWIs on dynamic knee joint loading, and beneficial biomechanical effects (reduction in knee adduction moment) were observed in patients with mild to moderate medial knee OA, in particular when using full-length LWIs. However, despite beneficial biomechanical effects, there is insufficient evidence for clinically important effects or significant reductions in disease progression. Evaluating the effects of LWIs, our current understanding of OA pain should be taken into account, as LWIs may be part of a comprehensive biopsychosocial treatment. Future work on all of the variables that could influence clinical outcomes in order to decide in which subgroups of patients LWIs are (most) effective is necessary.

Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2006) Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 33:1152–1158PubMed

Reginster JY (2002) The prevalence and burden of arthritis. Rheumatology (Oxford) 41(Supp 1):3–6CrossRef

Ma VY, Chan L, Carruthers KJ (2014) The incidence, prevalence, costs and impact on disability of common conditions requiring rehabilitation in the US: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Arch Phys Med Rehabil 95:986–995PubMedCrossRef

Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 58:26–35PubMedCrossRefPubMedCentral

Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P (2012) American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken) 64:465–474CrossRef

Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P (2010) OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil 18:476–499PubMedCrossRef

Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, Gunther K, Hauselmann H, Herrero-Beaumont G, Kaklamanis P, Lohmander S, Leeb B, Lequesne M, Mazieres B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Serni U, Swoboda B, Verbruggen G, Zimmerman-Gorska I, Dougados M (2003) EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 62:1145–1155PubMedCrossRefPubMedCentral

Bennell KL, Hunter DJ, Hinman RS (2012) Management of osteoarthritis of the knee. BMJ 345:e4934PubMedCrossRef

Johnson F, Leitl S, Waugh W (1980) The distribution of load across the knee. A comparison of static and dynamic measurements. J Bone Joint Surg (Br) 62:346–349

10.

Miyazaki T, Wada M, Kawahara H, Sato M, Baba H, Shimada S (2002) Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Ann Rheum Dis 61:617–622PubMedCrossRefPubMedCentral

11.

Bennell KL, Bowles KA, Wang Y, Cicuttini F, Davies-Tuck M, Hinman RS (2011) Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis. Ann Rheum Dis 70:1770–1774PubMedCrossRef

12.

Hurwitz DE, Sumner DR, Andriacchi TP, Sugar DA (1998) Dynamic knee loads during gait predict proximal tibial bone distribution. J Biomech 31:423–430PubMedCrossRef

13.

Birmingham TB, Hunt MA, Jones IC, Jenkyn TR, Giffin JR (2007) Test-retest reliability of the peak knee adduction moment during walking in patients with medial compartment knee osteoarthritis. Arthritis Rheum 57:1012–1017PubMedCrossRef

14.

Zhao D, Banks SA, Mitchell KH, D'Lima DD, Colwell CW Jr, Fregly BJ (2007) Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res 25:789–797PubMedCrossRef

15.

Thorp LE, Sumner DR, Block JA, Moisio KC, Shott S, Wimmer MA (2006) Knee joint loading differs in individuals with mild compared with moderate medial knee osteoarthritis. Arthritis Rheum 54:3842–3849PubMedCrossRef

16.

Thorp LE, Sumner DR, Wimmer MA, Block JA (2007) Relationship between pain and medial knee joint loading in mild radiographic knee osteoarthritis. Arthritis Rheum 57:1254–1260PubMedCrossRef

17.

Lidtke RH, Muehleman C, Kwasny M, Block JA (2010) Foot center of pressure and medial knee osteoarthritis. J Am Podiatr Med Assoc 100:178–184PubMedCrossRef

18.

Maillefert JF, Hudry C, Baron G, Kieffert P, Bourgeois P, Lechevalier D, Coutaux A, Dougados M (2001) Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: a prospective randomized controlled study. Osteoarthr Cartil 9:738–745PubMedCrossRef

19.

Butler RJ, Marchesi S, Royer T, Davis IS (2007) The effect of a subject-specific amount of lateral wedge on knee mechanics in patients with medial knee osteoarthritis. J Orthop Res 25:1121–1127PubMedCrossRef

20.

Hinman RS, Payne C, Metcalf BR, Wrigley TV, Bennell KL (2008) Lateral wedges in knee osteoarthritis: what are their immediate clinical and biomechanical effects and can these predict a three-month clinical outcome? Arthritis Rheum 59:408–415PubMedCrossRef

21.

Draganich L, Reider B, Rimington T, Piotrowski G, Mallik K, Nasson S (2006) The effectiveness of self-adjustable custom and off-the-shelf bracing in the treatment of varus gonarthrosis. J Bone Joint Surg Am 88:2645–2652PubMedCrossRef

22.

Pollo FE, Otis JC, Backus SI, Warren RF, Wickiewicz TL (2002) Reduction of medial compartment loads with valgus bracing of the osteoarthritic knee. Am J Sports Med 30:414–421PubMed

23.

Larmer PJ, Reay ND, Aubert ER, Kersten P (2013) A systematic review of guidelines for the physical management of osteoarthritis. Arch Phys Med Rehabil

24.

Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, Lohmander LS, Lund H, Mallen CD, Nava T, Oliver S, Pavelka K, Pitsillidou I, da Silva JA, de la Torre J, Zanoli G, Vliet Vlieland TP (2013) EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 72:1125–1135PubMedCrossRef

25.

Malfait AM, Schnitzer TJ (2013) Towards a mechanism-based approach to pain management in osteoarthritis. Nat Rev Rheumatol 9:654–664PubMedCrossRef

26.

Gifford LS, Butler DS (1997) The integration of pain sciences into clinical practice. J Hand Ther 10:86–95PubMedCrossRef

27.

Lluch Girbes E, Nijs J, Torres-Cueco R, Lopez Cubas C (2013) Pain treatment for patients with osteoarthritis and central sensitization. Phys Ther 93:842–851PubMedCrossRef

28.

Lluch Girbes E, Torres R, Nijs J, Van Oosterwijck J (2014) Evidence for central sensitization in patients with osteoarthritis pain: a systematic literature review. Eur J Pain In press

29.

Hodges PW, Tucker K (2011) Moving differently in pain: a new theory to explain the adaptation to pain. Pain 152:18CrossRef

30.

Hodges PW, Coppieters MW, MacDonald D, Cholewicki J (2013) New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches. Eur J Pain 17:1138–1146PubMedCrossRef

31.

Nijs J, Daenen L, Cras P, Struyf F, Roussel N, Oostendorp RAB (2012) Nociception affects motor output a review on sensory-motor interaction with focus on clinical implications. Clin J Pain 28:175–181PubMedCrossRef

32.

Crenshaw SJ, Pollo FE, Calton EF (2000) Effects of lateral-wedged insoles on kinetics at the knee. Clin Orthop Relat Res :185–192

33.

Kakihana W, Akai M, Yamasaki N, Takashima T, Nakazawa K (2004) Changes of joint moments in the gait of normal subjects wearing laterally wedged insoles. Am J Phys Med Rehabil 83:273–278PubMedCrossRef

34.

Nester CJ, van der Linden ML, Bowker P (2003) Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait Posture 17:180–187PubMedCrossRef

35.

Kerrigan DC, Lelas JL, Goggins J, Merriman GJ, Kaplan RJ, Felson DT (2002) Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis. Arch Phys Med Rehabil 83:889–893PubMedCrossRef

36.

Hinman RS, Bowles KA, Payne C, Bennell KL (2008) Effect of length on laterally-wedged insoles in knee osteoarthritis. Arthritis Rheum 59:144–147PubMedCrossRef

37.

Butler RJ, Barrios JA, Royer T, Davis IS (2009) Effect of laterally wedged foot orthoses on rearfoot and hip mechanics in patients with medial knee osteoarthritis. Prosthet Orthot Int 33:107–116PubMedCrossRef

38.

Hinman RS, Bowles KA, Bennell KL (2009) Laterally wedged insoles in knee osteoarthritis: do biomechanical effects decline after one month of wear? BMC Musculoskelet Disord 10:146PubMedCrossRefPubMedCentral

39.

Hinman RS, Bowles KA, Metcalf BB, Wrigley TV, Bennell KL (2012) Lateral wedge insoles for medial knee osteoarthritis: effects on lower limb frontal plane biomechanics. Clin Biomech (Bristol, Avon) 27:27–33CrossRef

40.

Reeves ND, Bowling FL (2011) Conservative biomechanical strategies for knee osteoarthritis. Nat Rev Rheumatol 7:113–122PubMedCrossRef

41.

Radzimski AO, Mundermann A, Sole G (2012) Effect of footwear on the external knee adduction moment—a systematic review. Knee 19:163–175PubMedCrossRef

42.

Jones RK, Chapman GJ, Findlow AH, Forsythe L, Parkes MJ, Sultan J, Felson DT (2013) A new approach to prevention of knee osteoarthritis: reducing medial load in the contralateral knee. J Rheumatol 40:309–315PubMedCrossRef

43.

Barrios JA, Butler RJ, Crenshaw JR, Royer TD, Davis IS (2013) Mechanical effectiveness of lateral foot wedging in medial knee osteoarthritis after 1 year of wear. J Orthop Res 31:659–664PubMedCrossRefPubMedCentral

44.

Kakihana W, Torii S, Akai M, Nakazawa K, Fukano M, Naito K (2005) Effect of a lateral wedge on joint moments during gait in subjects with recurrent ankle sprain. Am J Phys Med Rehabil 84:858–864PubMedCrossRef

45.

Shelburne KB, Torry MR, Steadman JR, Pandy MG (2008) Effects of foot orthoses and valgus bracing on the knee adduction moment and medial joint load during gait. Clin Biomech (Bristol, Avon) 23:814–821CrossRef

46.

Maly MR, Culham EG, Costigan PA (2002) Static and dynamic biomechanics of foot orthoses in people with medial compartment knee osteoarthritis. Clin Biomech (Bristol, Avon) 17:603–610CrossRef

47.

Kakihana W, Akai M, Nakazawa K, Takashima T, Naito K, Torii S (2005) Effects of laterally wedged insoles on knee and subtalar joint moments. Arch Phys Med Rehabil 86:1465–1471PubMedCrossRef

48.

Kakihana W, Akai M, Nakazawa K, Naito K, Torii S (2007) Inconsistent knee varus moment reduction caused by a lateral wedge in knee osteoarthritis. Am J Phys Med Rehabil 86:446–454PubMedCrossRef

49.

Kuroyanagi Y, Nagura T, Matsumoto H, Otani T, Suda Y, Nakamura T, Toyama Y (2007) The lateral wedged insole with subtalar strapping significantly reduces dynamic knee load in the medial compartment gait analysis on patients with medial knee osteoarthritis. Osteoarthr Cartil 15:932–936PubMedCrossRef

50.

Toda Y, Segal N (2002) Usefulness of an insole with subtalar strapping for analgesia in patients with medial compartment osteoarthritis of the knee. Arthritis Rheum 47:468–473PubMedCrossRef

51.

Nakajima K, Kakihana W, Nakagawa T, Mitomi H, Hikita A, Suzuki R, Akai M, Iwaya T, Nakamura K, Fukui N (2009) Addition of an arch support improves the biomechanical effect of a laterally wedged insole. Gait Posture 29:208–213PubMedCrossRef

52.

Shimada S, Kobayashi S, Wada M, Uchida K, Sasaki S, Kawahara H, Yayama T, Kitade I, Kamei K, Kubota M, Baba H (2006) Effects of disease severity on response to lateral wedged shoe insole for medial compartment knee osteoarthritis. Arch Phys Med Rehabil 87:1436–1441PubMedCrossRef

53.

Kutzner I, Damm P, Heinlein B, Dymke J, Graichen F, Bergmann G (2011) The effect of laterally wedged shoes on the loading of the medial knee compartment-in vivo measurements with instrumented knee implants. J Orthop Res 29:1910–1915PubMedCrossRef

54.

Chevalier TL, Chockalingam N (2012) Effects of foot orthoses: how important is the practitioner? Gait Posture 35:383–388PubMedCrossRef

55.

Russell EM, Hamill J (2011) Lateral wedges decrease biomechanical risk factors for knee osteoarthritis in obese women. J Biomech 44:2286–2291PubMedCrossRef

56.

Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF (1988) Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 109:18–24PubMedCrossRef

57.

Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM (2008) Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum 59:1207–1213PubMedCrossRef

58.

Brouwer RW, Jakma TS, Verhagen AP, Verhaar JA, Bierma-Zeinstra SM (2005) Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Syst Rev :CD004020

59.

Marks R, Penton L (2004) Are foot orthotics efficacious for treating painful medial compartment knee osteoarthritis? A review of the literature. Int J Clin Pract 58:49–57PubMedCrossRef

60.

Gelis A, Coudeyre E, Hudry C, Pelissier J, Revel M, Rannou F (2008) Is there an evidence-based efficacy for the use of foot orthotics in knee and hip osteoarthritis? Elaboration of French clinical practice guidelines. Joint Bone Spine 75:714–720PubMedCrossRef

61.

Reilly KA, Barker KL, Shamley D (2006) A systematic review of lateral wedge orthotics—how useful are they in the management of medial compartment osteoarthritis? Knee 13:177–183PubMedCrossRef

62.

Segal NA (2012) Bracing and orthoses: a review of efficacy and mechanical effects for tibiofemoral osteoarthritis. PM R 4:S89–S96PubMedCrossRef

63.

Raja K, Dewan N (2011) Efficacy of knee braces and foot orthoses in conservative management of knee osteoarthritis: a systematic review. Am J Phys Med Rehabil 90:247–262PubMedCrossRef

64.

Parkes MJ, Maricar N, Lunt M, LaValley MP, Jones RK, Segal NA, Takahashi-Narita K, Felson DT (2013) Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis. JAMA 310:722–730PubMedCrossRef

65.

Penny P, Geere J, Smith TO (2013) A systematic review investigating the efficacy of laterally wedged insoles for medial knee osteoarthritis. Rheumatol Int 33:2529–2538PubMedCrossRef

66.

Hinman RS, Bennell KL (2009) Advances in insoles and shoes for knee osteoarthritis. Curr Opin Rheumatol 21:164–170PubMedCrossRef

67.

Nijs J, Roussel N, Paul van Wilgen C, Koke A, Smeets R (2013) Thinking beyond muscles and joints: therapists' and patients' attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther 18:96–102PubMedCrossRef

68.

Cagnie B, Coppieters I, Denecker S, Six J, Danneels L, Meeus M (2014) Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Semin Arthritis Rheum

69.

King CD, Sibille KT, Goodin BR, Cruz-Almeida Y, Glover TL, Bartley E, Riley JL, Herbert MS, Sotolongo A, Schmidt J, Fessler BJ, Redden DT, Staud R, Bradley LA, Fillingim RB (2013) Experimental pain sensitivity differs as a function of clinical pain severity in symptomatic knee osteoarthritis. Osteoarthr Cartil 21:1243–1252PubMedCrossRef

70.

Woolf CJ (2011) Central sensitization: implications for the diagnosis and treatment of pain. Pain 152:S2–S15PubMedCrossRefPubMedCentral

71.

Staud R, Craggs JG, Robinson ME, Perlstein WM, Price DD (2007) Brain activity related to temporal summation of C-fiber evoked pain. Pain 129:130–142PubMedCrossRefPubMedCentral

72.

Meeus M, Nijs J, Van de Wauwer N, Toeback L, Truijen S (2008) Diffuse noxious inhibitory control is delayed in chronic fatigue syndrome: an experimental study. Pain 139:439–448PubMedCrossRef

73.

Meeus M, Nijs J (2007) Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin Rheumatol 26:465–473PubMedCrossRefPubMedCentral

74.

Zhuo M (2007) A synaptic model for pain: long-term potentiation in the anterior cingulate cortex. Mol Cells 23:259–271PubMed

75.

Somers TJ, Keefe FJ, Godiwala N, Hoyler GH (2009) Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions. Curr Opin Rheumatol 21:501–506PubMedCrossRef

76.

Dieppe PA, Cushnaghan J, Shepstone L (1997) The Bristol 'OA500' study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthr Cartil 5:87–97PubMedCrossRef

77.

Kinds MB, Welsing PM, Vignon EP, Bijlsma JW, Viergever MA, Marijnissen AC, Lafeber FP (2011) A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee. Osteoarthr Cartil 19:768–778PubMedCrossRef

78.

Yusuf E, Kortekaas MC, Watt I, Huizinga TW, Kloppenburg M (2011) Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis 70:60–67PubMedCrossRef

79.

Baert IA, Staes F, Truijen S, Mahmoudian A, Noppe N, Vanderschueren G, Luyten FP, Verschueren SM (2013) Weak associations between structural changes on MRI and symptoms, function and muscle strength in relation to knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc

80.

Pham T, Maillefert JF, Hudry C, Kieffert P, Bourgeois P, Lechevalier D, Dougados M (2004) Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis. A two-year prospective randomized controlled study. Osteoarthr Cartil 12:46–55PubMedCrossRef

81.

Hunter DJ, Felson DT (2006) Osteoarthritis. BMJ 332:639–642PubMedCrossRefPubMedCentral

82.

Lories RJ, Luyten FP (2011) The bone-cartilage unit in osteoarthritis. Nat Rev Rheumatol 7:43–49PubMedCrossRef

83.

Bennell KL, Bowles KA, Payne C, Cicuttini F, Williamson E, Forbes A, Hanna F, Davies-Tuck M, Harris A, Hinman RS (2011) Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial. BMJ 342:d2912PubMedCrossRefPubMedCentral

84.

Leyland KM, Hart DJ, Javaid MK, Judge A, Kiran A, Soni A, Goulston LM, Cooper C, Spector TD, Arden NK (2012) The natural history of radiographic knee osteoarthritis: a fourteen-year population-based cohort study. Arthritis Rheum 64:2243–2251PubMedCrossRef

85.

Bartlett SJ, Ling SM, Mayo NE, Scott SC, Bingham CO 3rd (2011) Identifying common trajectories of joint space narrowing over two years in knee osteoarthritis. Arthritis Care Res (Hoboken) 63:1722–1728CrossRef

86.

Farina S, Valeriani M, Rosso T, Aglioti S, Tamburin S, Fiaschi A, Tinazzi M (2001) Transient inhibition of the human motor cortex by capsaicin-induced pain. A study with transcranial magnetic stimulation. Neurosci Lett 314:97–101PubMedCrossRef

87.

Valeriani M, Restuccia D, Di Lazzaro V, Oliviero A, Profice P, Le Pera D, Saturno E, Tonali P (1999) Inhibition of the human primary motor area by painful heat stimulation of the skin. Clin Neurophysiol 110:1475–1480PubMedCrossRef

88.

Le Pera DG-NT, Valeriani M, Oliviero A, Di Lazzaro V, Tonali PA, Arendt-Nielsen L (2001) Inhibition of motor system excitability at cortical and spinal level by tonic muscle pain. Clin Neurophysiol 112:1633–1641PubMedCrossRef

89.

Tucker K, Butler J, Graven-Nielsen T, Riek S, Hodges P (2009) Motor unit recruitment strategies are altered during deep-tissue pain. J Neurosci 29:10820–10826PubMedCrossRef

90.

Hodges PW, Ervilha UF, Graven-Nielsen T (2008) Changes in motor unit firing rate in synergist muscles cannot explain the maintenance of force during constant force painful contractions. J Pain 9:1169–1174PubMedCrossRef

91.

Murphy SL, Lyden AK, Phillips K, Clauw DJ, Williams DA (2011) Subgroups of older adults with osteoarthritis based upon differing comorbid symptom presentations and potential underlying pain mechanisms. Arthritis Res Ther 13:R135PubMedCrossRefPubMedCentral

92.

Graven-Nielsen T, Wodehouse T, Langford RM, Arendt-Nielsen L, Kidd BL (2012) Normalization of widespread hyperesthesia and facilitated spatial summation of deep-tissue pain in knee osteoarthritis patients after knee replacement. Arthritis Rheum 64:2907–2916PubMedCrossRef

93.

Aranda-Villalobos P, Fernandez-de-Las-Penas C, Navarro-Espigares JL, Hernandez-Torres E, Villalobos M, Arendt-Nielsen L, Arroyo-Morales M (2013) Normalization of widespread pressure pain hypersensitivity after total hip replacement in patients with hip osteoarthritis is associated with clinical and functional improvements. Arthritis Rheum 65:1262–1270PubMedCrossRef

Titel: The effect of lateral wedge insoles in patients with medial compartment knee osteoarthritis: balancing biomechanics with pain neuroscience
verfasst von: Isabel A. C. Baert
Jo Nijs
Mira Meeus
Enrique Lluch
Filip Struyf
Publikationsdatum: 01.11.2014
Verlag: Springer London
Erschienen in: Clinical Rheumatology / Ausgabe 11/2014
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-014-2668-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Das Risiko für Vorhofflimmern in der Bevölkerung steigt

02.05.2024 Vorhofflimmern Nachrichten

Das Risiko, im Lauf des Lebens an Vorhofflimmern zu erkranken, ist in den vergangenen 20 Jahren gestiegen: Laut dänischen Zahlen wird es drei von zehn Personen treffen. Das hat Folgen weit über die Schlaganfallgefährdung hinaus.

VHF-Ablation nützt wohl nur bei reduzierter Auswurfleistung

02.05.2024 Ablationstherapie Nachrichten

Ob die Katheterablation von Vorhofflimmern bei Patienten mit Herzinsuffizienz die Komplikationsraten senkt, scheint davon abzuhängen, ob die Auswurfleistung erhalten ist oder nicht. Das legen die Ergebnisse einer Metaanalyse nahe.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2014

Elevated levels of serum sCXCL16 in systemic lupus erythematosus; potential involvement in cutaneous and renal manifestations

Efficacy of an out-patient pain management programme for people with joint hypermobility syndrome

Dynamic changes in the numbers of different subsets of peripheral blood NK cells in patients with systemic lupus erythematosus following classic therapy

Hypereosinophilia and Seroconversion of Rheumatoid Arthritis

Correlation of oxidant status with oxidative tissue damage in patients with rheumatoid arthritis