Identification of good candidates for valgus bracing as a treatment for medial knee osteoarthritis

Abstract

The ability to predict good candidates for valgus bracing may improve issues of patient compliance and could enable the ability to train patients to respond better to bracing. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:351-356, 2018.

Contributions of muscles and external forces to medial knee load reduction due to osteoarthritis braces

“…In this study, there was no change in the knee adduction moment ( Figure 3E), and therefore a negligible contribution of the inverse dynamics load to changes in the medial and lateral knee contact forces due to bracing ( Figure 7). Thus, both braces reduced medial contact loads without substantially changing gait dynamics ( Indeed, we recently identified the external hip adduction moment as a potential "biomarker" to explain why some subjects achieve a greater medial load reduction [60].…”

“…A generic musculoskeletal model with 96 muscles and 3-degree-of-freedom (DOF) hip joints, 1 DOF knee joints, and 1 DOF ankle joints [39] was modified to include subject-specific static frontal plane alignment and frontal-plane hinge joints at medial and lateral knee contact locations [40,41]. These hinge joints were locked at 0 degrees during scaling and inverse kinematics, and remained at this default position when "unlocked" (in OpenSim terminology) to enable reporting of moments and muscle moment arms at each contact location.…”

Immediate and short-term effects of gait retraining on the knee joint moments and symptoms in patients with early tibiofemoral joint osteoarthritis: a randomized controlled trial

“…Likewise, variablestiffness or lateral wedged walking shoes have been shown to reduce the KAM as well as decrease pain and increase function 9e12 . While the above interventions are effective for some patients (e.g., Clouthier et al 2017 13 and Haim et al 2012 9 ), they do not address the underlying motor pattern and they require that a device be worn, which can lead to compliance issues 14,15 . Moreover, such mechanical effects of the interventions disappear when the device is removed.…”

Prospective validity of a clinical prediction rule for response to non-surgical multidisciplinary management of knee osteoarthritis in tertiary care: a multisite prospective longitudinal study

“…Additionally, patients considered at risk of a poor response to nonsurgical management may be more closely monitored to escalate surgical consideration if no benefits are determined. However, while several studies have explored risk factors predictive of a poor response to non-surgical management of knee osteoarthritis, [11][12][13][14][15][16][17][18] those that have developed clinical prediction rules have not undergone prospective evaluation of its accuracy in identifying those at risk of poor response, particularly to non-surgical management of knee osteoarthritis. Prospective evaluation is a necessary second stage in the development and evaluation of clinical prediction rules.…”