How often do orthotics need to be completely replaced compared to refurbished or remade from the same cast, in terms of orthotic (orthopedic) device recasting?

From the Guidelines

Orthotics typically need to be completely recast and replaced every 3-5 years for adults and every 1-2 years for children, as the shape of feet and biomechanical needs change over time due to various factors. This recommendation is based on the general consensus in the field, as there is a lack of reliable evidence to provide a more specific guideline, as noted in the American Academy of Orthopaedic Surgeons clinical practice guideline summary 1.

Key Considerations

• The need for recasting versus refurbishment depends on several factors, including the type of orthotic material, patient activity level, weight, and changes in foot structure or medical condition.
• Refurbishment, which includes replacing worn components, may be needed every 6-12 months, but this is less extensive and costly than complete replacement.
• Signs that indicate complete recasting is necessary include persistent pain despite refurbishment, visible structural damage to the orthotic shell, or significant changes in gait, foot shape, or medical condition.

Maintenance Schedule

• Regular assessment by a podiatrist or orthotist is crucial to determine the appropriate maintenance schedule for individual needs, as the frequency of recasting and refurbishment can vary significantly from one patient to another.
• The decision between recasting and refurbishing should be made on a case-by-case basis, taking into account the patient's specific circumstances and the condition of the orthotic device, as suggested by the implication that practitioners should remain alert to new information and weigh the current recommendation 1.

From the Research

Orthotics Replacement and Refurbishment

• The provided studies do not directly address the frequency of orthotics replacement or refurbishment 2, 3, 4, 5, 6.
• However, the studies suggest that foot orthoses can be effective in reducing pain and improving function in patients with various musculoskeletal disorders, but the duration of their effectiveness and the need for replacement or refurbishment are not explicitly stated.
• A study on the effectiveness of foot orthoses for plantar heel pain found that there was moderate-quality evidence that foot orthoses were effective at reducing pain in the medium term, but it is uncertain whether this is a clinically important change 4.
• Another study found that foot orthoses can improve postural stability via a somatosensory or biomechanical effect, but the study did not address the frequency of replacement or refurbishment 5.
• A systematic review of the effects of foot orthoses on the biomechanics of the lower extremities found that foot orthoses mainly affected the biomechanics of the distal segments during most tasks, but the study did not address the frequency of replacement or refurbishment 6.

Key Findings

• The provided studies do not provide direct evidence on the frequency of orthotics replacement or refurbishment.
• Foot orthoses can be effective in reducing pain and improving function in patients with various musculoskeletal disorders.
• The effectiveness of foot orthoses can vary depending on the specific condition being treated and the individual patient.
• Further research is needed to determine the optimal frequency for replacing or refurbishing orthotics.