Objective To assess the effect of lateral wedge insoles compared with flat control insoles on improving symptoms and slowing structural disease progression in medial knee osteoarthritis.

Objective. To assess immediate effects of laterally wedged insoles on walking pain, external knee adduction moment, and static alignment, and whether these immediate effects together with age, body mass index, and disease severity predict clinical outcome after 3 months of wearing insoles in medial knee osteoarthritis. Conclusion. Lateral wedges immediately reduced knee adduction moment and walking pain but had no effect on static alignment. Although some parameters predicted clinical outcome, these explained only one-third of the variance, suggesting that other unknown factors are also important.

The purpose of this study was to elucidate the effect of normal fluctuating [non-monophasic oral contraceptive pill (MOCP) users] and low, consistent (MOCP users) endogenous plasma estrogen levels on the strain behavior of the Achilles tendon in vivo. Twenty women (age 28.0 +/- 4.2 yr, height 1.67 +/- 0.07 m, mass 61.6 +/- 6.8 kg) who had been using the MOCP for at least 12 mo together with 20 matched women who were non-MOCP users (age 31.9 +/- 7.3 yr, height 1.63 +/- 0.05 m, mass 62.5 +/- 5.9 kg) participated in this study. Non-MOCP users were tested at the time of lowest (menstruation) and highest (approximately same as ovulation) estrogen, whereas MOCP users, who exhibited constant and attenuated endogenous estrogen levels, were tested at day 1 and day 14 of their cycle. At each test session, maximal isometric plantarflexion efforts were performed on a calf-raise apparatus while synchronous real-time ultrasonography of the triceps surae aponeurosis was recorded. Achilles tendon strain (%) was calculated by dividing tendon displacement during plantarflexion by resting tendon length. Repeated-measures ANOVA revealed a significant (P < 0.05) main effect of subject group with significantly lower Achilles strain (25.5%) in the MOCP users compared with the non-MOCP users. In conclusion, acute fluctuations in plasma estrogen across the menstrual cycle in non-MOCP users did not alter the strain behavior of the Achilles tendon. Conversely, long-term exposure to attenuated estrogen in MOCP users resulted in a decrease in Achilles tendon strain, which is thought to be attributed to the effects of endogenous estrogen on collagen synthesis. These findings have a number of important functional and clinical implications.

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Objective To identify the prevalence of diabetes‐related lower‐limb amputations and its regional variations in Australia. Design and setting Cross‐sectional analysis of a hospital morbidity dataset in Australia. Methods Analysis of the National Hospital Morbidity Database of all hospital separations for the ICD codes 84.10‐84.19 (lower‐limb amputations) and 250.0‐250.9 (diabetes and its complications) for the financial years 1995‐96 to 1997‐98. Main outcome measure Number of lower‐limb amputations in people with diabetes mellitus in Australia, and in each State and Territory. Results 7887 diabetes‐related lower‐limb amputations were reported during the study period, with a mean±SD of 2629±47 per year. The prevalence in Australia was 13.97 per 100 000 total population, and varied from 11.34 per 100 000 in the Australian Capital Territory to 20.68 per 100 000 in South Australia. Conclusion Diabetes‐related lower‐limb amputation poses a substantial personal and public health cost in Australia.

Background: People with diabetes and peripheral neuropathy often do not implement the footcare behavioural strategies that are suggested by many health professionals. The concept of selfefficacy has been shown to be an effective predictor of behaviour in many areas of health. This study investigated the relationships between foot-care self-efficacy beliefs, self-reported foot-care behaviour and history of diabetes-related foot pathology in people with diabetes and loss of protective sensation in their feet.