Dear Sood, It is indeed possible to alter tibial alignment using orthotic
intervention at the distal end of the kinetic chain. On the understanding
that pronation at the subtalar joint causes tibial internal rotation, then
prevention of excess pronation using orthotics will prevent excess tibial
int rotation, if this is in fact the cause of medial compartment stress in
the knee. Remember that pronation is passive, gravity-driven, and
abnormalities in foot and ankle alignment are the principal culprits. I
recommend orthotic intervention as a first line of treatment, before
surgery is considered. Regards, Martin Kidd.
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From: sood <[log in to unmask]>
To: [log in to unmask]; [log in to unmask]; indiaorth
<[log in to unmask]>
Subject: TIBIAL OSTEOTOMY FOR OA KNEE
Date: Friday, 25 June 1999 05:48
Dear friends,
Can anyone outline biomechanics responsible for medial
compartmental osteo-arthitis ? How it is helped by high tibial
osteotomy? As the patient attempts to bear weight onlateral compartment of
knee this is responsible for the typical gait of these patients.My
question to house is "is it possible to shift the weight of
these patients away from medial compartment to the latral compartment using
some orthotics or some type of footwear" .hence not only relieving the pain
but correction of gait can take place.
thanks all
Dr.Sarveshwar Chander Sood,
Orthopaedic Surgeon & Head,
Dept. of Physical Medicine & Rehabilitation,
SBLS Civil Hospital Jalandhar city, Punjab state, India.
Res:812/1 Housing Board Colony Model Town, Jalandhar city, India
[log in to unmask]
http://personal.vsnl.sarvesh/com.
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