An Arthritis Research UK-funded study has cast doubt on the effectiveness of using lateral wedge insoles as a means of relieving pain levels among sufferers of medial knee osteoarthritis.
Medial knee osteoarthritis is the most common type of arthritis affecting the knee joint, affecting the inside of the knee between the femur and the tibia.
The University of Manchester team led by Dr Matthew Parkes assessed the efficacy of lateral wedge treatments – shoes and insoles designed to reduce pressure on the knee – in reducing pain, evaluating data from 12 trials involving almost 900 patients.
According to results published in the Journal of the American Medical Association, while the data showed some connection between the use of these wedges and a reduction in pain levels, the findings were extremely inconsistent and failed to provide any evidence of a clear link.
Moreover, the studies that compared lateral wedge treatments to neutral insoles showed there were no advantages at all associated with the lateral wedge options.
This type of insole fits underneath the sole of the shoe and are thicker on the outside than the inside, thereby tilting the foot inward and transferring the weight of the body to a different part of the foot.
However, the Arthritis Research UK-backed report would appear to suggest that the specific design of the insole itself did not have an impact, with the only studies showing any benefit being the ones in which their performance was compared against patients who were not using insoles at all.
The researchers said: ‘These results suggest that compared with control interventions, lateral wedges are not efficacious for the treatment of knee pain in persons with medial knee osteoarthritis.’
Arthritis Research UK is now funding a new clinical trial that will see the Manchester team investigating whether targeting specific sub-groups of people with medial osteoarthritis who respond biologically to wearing lateral wedge insoles gain benefit. A number of insoles and orthotics which have been designed to potentially lower the loads in the knee joint will be tested.

‘The current way that insoles are prescribed don’t appear to work, but this new trial gives us an opportunity to modify them for particular patients whom we think will respond,’ added the spokesman. Arthritis Research UK

Researchers at St. Michael

Many men with low-risk, localised prostate cancers can safely choose active surveillance or ‘watchful waiting’ instead of undergoing immediate treatment and have better quality of life while reducing health care costs, according to a study by researchers at Dana-Farber Cancer Institute and Massachusetts General Hospital.
They say that their statistical models showed that ‘observation is a reasonable and, in some situations, cost-saving alternative to initial treatment’ for the estimated 70 percent of men whose cancer is classified as low-risk at diagnosis.
The researchers, led by Julia Hayes, MD, a medical oncologist in the Lank Center for Genitourinary Oncology at Dana-Farber, said their findings support observation – active surveillance and watchful waiting – as a reasonable and underused option for men with low-risk disease.
‘About 70 percent of men in this country have low-risk prostate cancer, and it

The Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study showed CRT, a standard of care in heart failure patients with a wide QRS, is not beneficial in patients with heart failure and a narrow QRS complex, below 130 milliseconds (msec).
The results reaffirm current guidelines excluding patients with a narrow QRS for CRT, and expand the body of evidence that simple electrocardiographic determination of QRS duration remains the most important predictor of the clinical benefits of CRT, rather than measures of mechanical dyssynchrony by echocardiography. Based on the results of EchoCRT, the identification of patients who will obtain the benefit of CRT can be done most easily by a 12 lead-ECG.

‘Results from previous smaller trials had suggested a potential for CRT in heart failure patients with narrow QRS. EchoCRT now provides evidence from a definite outcome trial that patients with symptomatic heart failure with QRS width less than 130msec do not benefit from CRT,’ said co-lead investigator Frank Ruschitzka, MD, from the University Hospital in Zurich, Switzerland.
‘The EchoCRT trial evaluated an important question for daily clinical practice. The results will help to guide physicians

A novel drug may help increase the effectiveness of radiation therapy for the most deadly form of brain cancer, report scientists at Virginia Commonwealth University Massey Cancer Center. In mouse models of human glioblastoma multiforme (GBM), the new drug helped significantly extend survival when used in combination with radiation therapy.

The study provides the first pre-clinical evidence demonstrating that an ATM kinase inhibitor radiosensitizes gliomas. Gliomas are brain tumours that originate from glial cells, which provide support for nerve cells and help regulate the internal environment of the brain. ATM, or ataxia telangiectasia mutated, is an enzyme that helps repair DNA damage. The scientists used an experimental drug, KU-60019, to block the activation of ATM, which led to the enhanced destruction of the gliomas due to their reduced ability to repair the DNA damage caused by the radiation treatment. The new approach was particularly effective against gliomas that have a mutation in the p53 tumour suppressor gene, which accounts for approximately 30 percent of all glioma cases.

‘Sadly, the average life expectancy of patients diagnosed with glioblastoma is just 12 to 15 months,’ says the study