A biomechanical analysis of a medial unloading brace for osteoarthritis in the knee

Self, Brian P.; Greenwald, Richard M.; Pflaste, Daniel S.

doi:10.1002/1529-0131(200008)13:4<191::aid-anr3>3.0.co;2-c

Cited by 106 publications

(89 citation statements)

References 9 publications

(9 reference statements)

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“…The mean value of 0.040 Nm/kg and the mean maximum value of 0.053 Nm/kg for this cohort correlate well with prior studies using different instrumented braces. Self et al indicated values of 0.038 and 0.050 Nm/kg [16], the values reported by Pollo et al were 0.071 and 0.133 Nm/kg [20], and the latest study compare favorably with the value of 10 percent found in this study. Larger effects with the brace calculated in some studies may reflect orthoses tightened so snugly that they would not be well tolerated by the patients in real world use.…”

Section: Discussionsupporting

confidence: 76%

“…Contradictory results from other studies [14][15][16] may be an artifact of different investigation approaches (e.g., use of instrumented braces, unrealistically tight adjustments of the braces). Results from previous studies on the effect of braces on knee axis movements are also equivocal.…”

Section: Discussionmentioning

confidence: 96%

“…Scientific investigations of the effect of a knee brace on the external varus moment report either a reduced varus moment [14][15][16] or no significant change in this biomechanical parameter [17][18][19]. These contradictory results raise questions about whether or not forces produced by knee braces are sufficient to significantly alter the external moment.…”

Section: Introductionmentioning

confidence: 99%

“…For this reason, previous studies have used specially designed test braces with highly precise integrated sensors to directly measure the valgus moment created by the brace [16,20,22].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee

Schmalz

Knopf²,

Drewitz³

et al. 2010

JRRD

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Abstract-The biomechanical effectiveness of a valgusinducing knee brace was investigated for 16 patients with knee osteoarthritis (mean +/-standard deviation age 56 +/-10 yr, height 172 +/-9 cm, mass 83 +/-7 kg, body mass index 27.6 +/-4.5 kg/m 2 ). At the time of investigation, all subjects had been wearing the brace for at least 4 weeks. In addition to conducting standard gait analysis, we calculated the valgus moment generated by the brace by using a novel system that measured the actual deformation of the brace during stance phase and determined the reaction force created by the brace on the leg. The mean maximum value of the orthotic valgus moment was 0.053 Nm/kg, which represents approximately 10% of the external genu varus moment without the brace. This finding may explain the pain relief reported by patients using such braces in clinical studies. Use of the tested brace also decreased the magnitude of gait asymmetry between the braced and contralateral legs during walking (horizontal ground reaction force, external knee flexion moment), presumably because the subjects' need to walk abnormally to shield the knee from pain was reduced.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

“…For this reason, previous studies have used specially designed test braces with highly precise integrated sensors to directly measure the valgus moment created by the brace [16,20,22].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee

Schmalz

Knopf²,

Drewitz³

et al. 2010

JRRD

View full text Add to dashboard Cite

show abstract

“…For example, instructions on proper use of a cane on the side contralateral to the arthritic knee joint can be used as an early offloading strategy, by shifting a portion of the body mass off the symptomatic knee tissues during weight-bearing activities such as walking. 107,125 Full-length laterally wedged insoles 45,[76][77][78] or valgus knee bracing 46,120,170,197 may also be effective in modifying the tibiofemoral joint angle and the dynamic loading of the knee joint, thereby decreasing medial compartment compressive loads. Additionally, gait retraining strategies to reduce walking speed, especially in patients with less severe disease, 139 could be an effective offloading approach on a short-term basis.…”

Section: Short-term Treatment Optionsmentioning

confidence: 99%

A Biomechanical Perspective on Physical Therapy Management of Knee Osteoarthritis

Farrokhi¹,

Voycheck²,

Tashman³

et al. 2013

J Orthop Sports Phys Ther

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Effect of a Realigning Brace on Tibiofemoral Contact Stress

Segal

Stockman

Findlay

et al. 2015

Arthritis Care & Research

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Objective. To determine the degree to which focally elevated tibiofemoral joint contact stress is reduced by using a frontal plane realigning brace. Methods. Fifteen volunteers (9 women) with unicompartmental tibiofemoral osteoarthritis underwent weight-bearing radiographic imaging at 15-208 and 5-108 of knee flexion with and without an UnloaderOne knee brace. Discrete element analysis was used to estimate compartment-specific contact stress distributions. Paired t-tests were used to assess the differences in mean contact stress and contact stress distributions, comparing the braced and unbraced conditions. Results. The mean 6 SD age was 56.1 6 6.4 years and body mass index was 28.4 6 4.5 kg/m 2 . Twelve of 15 participants were fit with braces set to unload the medial compartment. For the 15-208 condition, the mean contact stress in the compartment of interest did not significantly change (0.08 6 0.35 MPa; P 5 0.410). Also at 5-108 flexion, the mean contact stress in the compartment of interest did not significantly change with use of the brace (0.24 6 0.45 MPa; P 5 0.175). Conclusion. This is the first study of the effects of a frontal plane realignment brace on in vivo articular contact stress in native human knees. Using the off-the-shelf brace tested, there were no changes in compartmental tibiofemoral contact stress distributions at either 15-208 or 5-108 of knee flexion, revealing no redistribution of contact stress away from the compartment of interest. These findings indicate that the brace that was studied was ineffective for redistributing tibiofemoral contact stress. Further research is necessary to determine whether double-upright or customized frontal plane braces are effective in redistributing compartmental articular contact stress.

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A biomechanical analysis of a medial unloading brace for osteoarthritis in the knee

Abstract: Objectives.

Cited by 106 publications

References 9 publications

Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee

Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee

A Biomechanical Perspective on Physical Therapy Management of Knee Osteoarthritis

Effect of a Realigning Brace on Tibiofemoral Contact Stress

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