Treatment of osteoarthritis of the knee with bracing: a scoping review

Abstract

Knee osteoarthritis is a leading cause of disability around the world. Knee bracing provides a conservative management option for symptom relief. A variety of different bracing types, manufacturers and products are currently available on the market. The goal of this study is to examine the current state of the literature regarding the treatment of knee osteoarthritis with unloader bracing, specifically examining the representation of specific brace types, manufacturers and models within the literature.A scoping review technique was used because of its ability to evaluate research activity within an area of study and identify gaps within the literature. A thorough search of the MEDLINE database was conducted for articles where a knee brace model was identified, and we identified characteristics of the studies to evaluate important information about the body of literature related to knee bracing for the treatment of osteoarthritis.Fifty eligible studies were identified. The majority of studies have been published in the United States, and a large increase in the number of publications in this field was seen between 2010-2014. The most prominent study type was prospective comparative studies (44%), however there is a lack of randomized controlled trials (6%) within the literature. The most prominent hinge type within the literature is the dual hinge push brace, followed by the single hinge pull.While a large increase in the number of studies evaluating the treatment of knee osteoarthritis with bracing has occurred in the past 5 years, there is a lack of high quality studies evaluating the efficacy of the technique, as well as a lack of studies comparing bracing types and models.

The use of stromal vascular fraction (SVF), platelet-rich plasma (PRP) and stem cells in the treatment of osteoarthritis: an overview of clinical trials

“…Exercise helps to strengthen the muscle around the affected joints, which, in turn, reduces pain and instability in patients. There is also some evidence that patients can benefit from knee braces and shoe orthotics [20]. Aside from these non-pharmacological suggestions, patients may benefit from nonsteroidal anti-inflammatory drugs (NSAIDS) as well as intra-articular inoculations of corticosteroids and hyaluronic acid (HA) [21,22].…”

Management of osteoarthritis of the knee in younger patients

“…Numerous studies have been published on the effi cacy of unloader bracing in knee osteoarthritis, and although a recent scoping review identified that 92% of studies supported their use, 94% of available research was nonrandomized or based upon expert opinion. 20 A metaanalysis of six RCTs comparing the use of a medial unloader knee brace for the treatment of medial compartment arthritis to a control orthosis found a small, statisti cally significant benefit favouring the brace for improvement in pain (standardized mean difference [SMD] 0.33, 95% CI 0.13 to 0.52) and function (SMD 0.22, 95% CI 0.02 to 0.41). 21 Because of the low quality of available evidence, the clinical importance of these findings remains unclear.…”

Biomechanical Study of a Tricompartmental Unloader Brace for Patellofemoral or Multicompartment Knee Osteoarthritis

“…Knee braces are a common conservative treatment option for reducing pain and improving function in people with musculoskeletal injuries and disease (Chew et al, 2007 ), such as knee osteoarthritis (OA) (Ramsey and Russell, 2009 ; Petersen et al, 2016 ; Phillips et al, 2016 ). Unicompartment off-loader braces are a common style of knee brace designed to reduce pain and progressive degeneration of the osteoarthritic knee by redistributing compressive forces away from the diseased medial or lateral tibiofemoral (TF) compartment via joint realignment (Ramsey et al, 2007 ; Briem and Ramsey, 2013 ).…”