10/5/2006 – The Sole of a Breakthrough

SCL Affiliate Tom Andriacchi has developed a special shoe that could literally shift medicine’s first line of defense against arthritis.

Forty million Americans suffer the pain and weakness of osteoarthritis, the deterioration of cartilage in the joint that long has been considered an aggravating and inevitable result of aging.

Now, the Stanford Center for Longevity’s Dr. Thomas Andriacchi and his team in the department of Bio-Mechanical Engineering are zeroing in on a novel, non-pharmaceutical, non-surgical approach to reducing pain and possibly inhibiting the progress of osteoarthritis in the knee. A new shoe design, indistinguishable from common sneakers but with a hidden secret, could represent an exciting new option for millions of people who currently rely on anti-inflammatory and steroid-based drugs that can have unwanted side effects. “This project represents precisely the kind of mission the Center was founded to support,” explains SCL Director Laura L. Carstensen. “We are determined to speed up the translation of research to practical solutions for an aging population anxious to remain active and fit for as long as possible.”

It’s all about sole. Specifically, a special design of composite material in a shoe that is firmer on one side than the other, prompting an ever so slight change in an individual’s gait. That gait shift moves pressure during walking away from painful, inflamed tissue in the knee. A study of more than 80 individuals between the ages of 50 and 70 with arthritis-related knee pain showed that wearing a prototype of this shoe at least four hours a day produced a noticeable decrease in knee pain, versus no change in individuals given an unmodified shoe to wear for the same period of time.

Andriacchi developed an early-stage development project with athletic shoe giant Nike to fund and test prototype shoes. In addition to the documented reduction in pain, Andriacchi, who has based the shoe’s design on research he’s been doing on arthritis for more than 20 years, says there is reason to believe that the gait change prompted by use of the shoe could actually slow the progression of osteoarthritis in the joint. Studies are underway now using magnetic resonance imaging to monitor physical changes in the knees of subjects wearing the shoe every day, over time.

The project has also drawn the interest of a team of students from the Graduate School of Business who have designed a potential business around the Andriacchi shoe.. They are exploring a number of the marketing issues associated with fine-tuning the finished product, from design to cost to target market. It is clear that a sneaker format is a straightforward and effective design to implement the shoe’s benefits, for example, but Andriacchi says his team is consulting with shoe designers to explore whether it could be incorporated into other shoe designs to fit a diversity of tastes and lifestyles. In the lab, researchers are determining whether the shoe can actually stop arthritis progression in its tracks. That feature could make the shoe an important aid to athletes, for example, who may have suffered injuries that make them more susceptible to early-onset arthritis.

Clearly, Andriacchi, his team, and the SCL feel a keen sense of urgency in developing this product. “By 2020, the number of people with osteoarthritis will rise to 59 million and it’s probably the major cause of people over 50 losing the ability to function in a normal array of activities,” Andriacchi explains. Adds Steve Goldband, Director of Private Sector Initiatives at SCL, “We are excited about the potential of this project to make an important contribution to the well-being of older adults. In this case, a viable commercial strategy will be crucial.”