Improvement in function after valgus bracing of the knee

Abstract

The use of a valgus brace can effectively relieve the symptoms of unicompartmental osteoarthritis of the knee. This study provides an objective measurement of function by analysis of gait symmetry. This was measured in 30 patients on four separate occasions: immediately before and after initial fitting and then again at three months with the brace on and off. All patients reported immediate symptomatic improvement with less pain on walking. After fitting the brace, symmetry indices of stance and the swing phase of gait showed a consistent and immediate improvement at 0 and 3 months, respectively, of 3.92% (p = 0.030) and 3.40% (p = 0.025) in the stance phase and 11.78% (p = 0.020) and 9.58% (p = 0.005) in the swing phase. This was confirmed by a significant improvement at three months in the mean Hospital for Special Surgery (HSS) knee score from 69.9 to 82.0 (p < 0.001). Thus, wearing a valgus brace gives a significant and immediate improvement in the function of patients with unicompartmental osteoarthritis of the knee, as measured by analysis of gait symmetry.

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

“…The clinical effectiveness of this medical device has been reported in previous studies (i.a., [3][4][5][6][7][8]). However, studies published to date show conflicting results regarding the biomechanical mechanism of the knee brace.…”

Valgus bracing in patients with medial compartment osteoarthritis of the knee

“…The results range from no effect to a significant improvement in gait symmetry and a reduction in external varus moments [2,5,[7][8][9][10]. A study using fluoroscopy during treadmill gait demonstrated articular surface separation at heel strike in subjects wearing valgus knee braces [11].…”

“…Furthermore, most valgus braces offer little flexibility and there is a need for more adjustable braces. A new valgus brace, the SofTec OA brace (Bauerfeind GmbH), www.elsevier.com/locate/gaitpost Gait & Posture 26 (2007) [3][4][5][6][7][8][9][10] has been constructed with only a lateral hinge including an air chamber that enables adjustment of the valgus force by the patient (Fig. 1).…”

“…Diagrams showing the group mean AE standard deviation of the (a) peak knee varus moment (normalized to body weight (BW) and height (HT)), (b) foot progression angle(8), (c) step length (cm) and (d) knee range of motion in the saggital plane(8) for both the unaffected and affected leg at all conditions. Significant differences are indicated with an asterisk (*).…”

Konservative Therapie der Arthrose

“…Pollo et al [44] berichteten in einer Vergleichsstudie über eine deutliche Re duktion der Belastung im medialen Ge lenkkompartiment durch Valgusbracing, Minnich et al [37] konnten in einer Gan ganalysestudie mit getragenen Osteoarth roseorthesen nach 10 Wochen deutliche Verbesserungen des Gangbildes bei be troffenen Patienten nachweisen, die glei chen Resultate fanden Draper et al [10]. Das CochraneReview aus dem Jahre 2005 führt für valgisierende Knieorthesen eine nachgewiesene Verbesserung der Osteo arthrosesymptomatik auf und beschreibt den Stellenwert zur konservativen The rapie der Osteoarthrose als unbestritten.…”