A Cohort-Controlled Trial of Custom-Made Foot Orthoses in Anserine Bursitis

Abstract

There is a lack of studies of foot orthosis use in the common condition of anserine bursitis. The aim of this study was to determine the proportion of subjects reporting recovery from anserine bursitis with prescribed custom-made foot orthoses in addition to local corticosteroid injection versus corticosteroid injection alone. Sixty-nine consecutive patients presenting with symptoms and findings compatible with a case definition for anserine bursitis were included in this study. A total of 35 subjects were prescribed a local corticosteroid injection into the anserine bursa under fluoroscopic guidance (control group), and 34 subjects were equally prescribed a fluoroscopically guided local corticosteroid injection with the addition of custom-made foot orthoses (orthoses group). All subjects completed the Oswestry Disability Index at baseline, and the number of subjects using prescribed analgesics for their knee pain was recorded at baseline and at follow-up of 8 weeks and 4 months. The subjects were asked at each follow-up if they felt that they had recovered from their knee pain. A total of 33 subjects in each group completed the study at 8 weeks, and 32 subjects in each group completed the 4-month follow-up. At 8 weeks, 55% reported recovery in the control group and 76% reported recovery in the orthoses group. The number of subjects who reported recovery at 4 months, however, was markedly different between the groups, with only 41% reporting recovery in the control group and 88% reporting recovery in the orthoses group. The addition of custom-made foot orthoses to local corticosteroid injection seems to improve the short- and long-term outcome with fewer recurrences. What is already known on this subject: 1) Anserine bursitis is a common condition. 2) There are no studies to date of foot orthosis use in the treatment approach. What this study adds: 1) This is the first controlled trial of custom-made foot orthoses in anserine bursitis, a common knee disorder. 2) Custom-made orthoses, when added to usual care for anserine bursitis, increase the likelihood of recovery at 8 weeks and 4 months. How it might impact on clinical practice in the near future: The addition of custom-made foot orthoses may increase the recovery rate from anserine bursitis.