Medial Knee OA quandary

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Hi All

I have a 44 YO male pt who has presented with R medial knee OA + associated pain and R lateral ankle pain (lateral gutter joint line pain on palpation, no neurological symtoms, pain is relieved when rearfoot is inverted). He has a history of excessive tibial varum (congenital) which was surgically corrected 2 years ago. The orthopods don't want to touch his knee for another 6-8 years.

Foot function = High supination resistance, medial deviated STJ axis, high jacks test, central heel strike, excessive rear foot pronation through mid to late midstance, low gear toe off.

I feel confident to treat the lateral ankle pain with orthoses, dealing with the medially deviated STJ and addressing the FF mechanics with reverse morton's. My only concern with this approach is it will increase the forces around the compromised medial compartment of the knee.

With this in mind would a device with a Lateral heel skive (which should help the knee OA) overload the lateral gutter of the ankle??

Any advice on this situation would be much appreciated.

Cheers

Brent