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Saturday, November 19, 2011

When Are Orthotic Devices Too Old and Should Be Replaced?

Collection of Custom Made Orthotic Devices

Patients present almost daily with orthotic devices made in the past  and want to know if they  are still okay to wear or should we make new ones. There are several common generalizations out there from every 2 years to every 5 years for rigid or semi-rigid orthotics, and every 6 months to one year for soft orthotics.
 I tend to take a different stand on this. First of all, I never want to see the orthotic (to avoid judging a book by it's cover) device until I have seen how the patient functions in it. Some pretty horrible looking orthotic devices work great and some high tech super duper ones look terrible at controlling the abnormal forces.
This week I had a patient Marilee in to evaluate her 20 year old orthotic devices, and they functioned just fine. I stole them for just one day to do standard refurbishing of the non plastic parts. And because she has somehow gone from 44 to 64 years old, I changed the posting on the heel to softer materials for more shock absorption. A little kinder on her knees which can bother her.
And there are times that new orthotic devices are made to change the purpose of the orthotic device used. So  basic orthotic devices used to stabilize the foot for plantar fasciitis in 1996 may not be stable enough or soft enough to help a knee problem in 2011.
Therefore, the general rules of keeping it simple stupid (KISS) do seem to apply here most of the time. The Orthotic Devices can be Too Old when they stop giving great function and allow the patient to walk and/or exercise better, when symptoms seem to be stubborn and orthotic changes may help, when new symptoms normally necessitate a different type of orthotic device all together, and of course, following foot/ankle surgery when the foot is now a different shape.
This only takes a little more thought than some protocol stating every 2 years or so whether the patient needs it or not. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.