Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis

Lee, Paul Yf; Winfield, Thomas G; Harris, Shaun; Storey, Emerald; Chandratreya, Amit

doi:10.1136/bmjsem-2016-000195

Cited by 34 publications

(60 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other unloading braces are typically focused on providing unicompartmental offloading of the TF joint [23][24][25][26][27][32][33][34] without addressing PF compartment loading. An important limitation of unicompartment offloaders is that as the offloading benefit is realized by one side of the TF joint, the opposite TF compartment experiences an increase in loading.…”

Section: Unloading Provided By the Tricompartment Unloadermentioning

confidence: 99%

“…As little as 5 deg varus/valgus malalignment can increase compressive loading in the TF compartment by up to 90% [29], so this redistribution of contact forces could increase the likelihood of the patient developing bicompartmental OA [28]. Similarly, braces designed to target the PF compartment do not address TF joint loading [35] and do not consistently provide clinical benefits [13]. However, the current analysis suggests the unloading benefits of the TCU brace may be experienced by all three knee joint compartments.…”

Section: Unloading Provided By the Tricompartment Unloadermentioning

confidence: 99%

“…1(a)) [28]. Unicompartment offloader braces are a cost-effective treatment method that can decrease pain, joint stiffness, and drug dosage, while increasing quality of life [30][31][32][33][34]. Unfortunately, because a low percentage (4%) of patients have unicompartmental TFOA [4], traditional unloader braces are not indicated for most patients with knee OA who are likely to have patellofemoral or multicompartmental disease [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Braces for PFOA are relatively uncommon and typically act by realigning the patella, thereby increasing joint contact area in order to reduce pressure [28]. However, limited evidence exists in support of their efficacy [13,35] and while patellar realignment could be useful in certain cases [12,36], existing PFOA braces are not intended to unload a correctly aligned PF joint during weight bearing knee flexion when the symptoms of PFOA are most aggravated [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Design Evaluation of a Novel Multicompartment Unloader Knee Brace

Budarick¹,

MacKeil²,

Fitzgerald³

et al. 2019

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

Knee osteoarthritis (OA) is a significant problem in the aging population, causing pain, impaired mobility, and decreased quality of life. Conservative treatment methods are necessary to reduce rapidly increasing rates of knee joint surgery. Recommended strategies include weight loss and knee bracing to unload knee joint forces. Although weight loss can be beneficial for joint unloading, knee OA patients often find it difficult to lose weight or begin exercise due to knee pain, and not all patients are overweight. Unicompartment offloader knee braces can redistribute joint forces away from one tibiofemoral (TF) compartment; however, <5% of patients have unicompartmental tibiofemoral osteoarthritis (TFOA), while patients with isolated patellofemoral or multicompartmental OA are much more common. By absorbing body weight (BW) and assisting the knee extension moment using a spring-loaded hinge, sufficiently powerful knee-extension-assist (KEA) braces could be useful for unloading the whole knee. This paper (1) describes the design of a spring-loaded tricompartment unloader (TCU) knee brace intended to provide unloading in all three compartments of the knee while weight-bearing, (2) measures and compares the force output of the TCU against the only published and commercially available KEA brace, and (3) calculates the static unloading capacity of each device. The TCU and KEA braces delivered maximum assistive moments equivalent to reducing BW by approximately 45 and 6 lbs, respectively. The paper concludes that sufficiently powerful spring-loaded knee braces show promise in a new class of multicompartment unloader knee orthoses, capable of providing a clinically meaningful unloading effect across all three knee compartments.

show abstract

Section: Unloading Provided By the Tricompartment Unloadermentioning

confidence: 99%

Section: Unloading Provided By the Tricompartment Unloadermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Design Evaluation of a Novel Multicompartment Unloader Knee Brace

Budarick¹,

MacKeil²,

Fitzgerald³

et al. 2019

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

show abstract

“…Valgus knee bracing is found to effectively correct the lower limb force lines, release pain feelings and improve joint functions of KOA patients by optimizing their biomechanical axis [10][11][12][13]. Kirkley et al [14] showed that valgus knee bracing can effectively reduce the pain symptom and joint mobility of KOA patients.…”

Section: Introductionmentioning

confidence: 99%

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: A meta-analysis of Randomized Trials

Fan

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: KOA, with a high incidence in old-age population, adversely affects their life quality. The valgus knee bracing is an important physical therapy for KOA, but its clinical effects on pain release and functional improvment are remained unclear. This meta-analysis is to systematically evaluate the clinical outcomes of valgus knee bracing in patients with knee osteoarthritis (KOA). Methods : A meta-analysis of clinical randomized controlled trials (RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period was ranged from the inception of the database to May, 2020. The enrolled research databases included PubMed, Embase, and Web of Science databases. Two investigators independently formulated inclusion criteria and exclusion criteria, screened and determined the final enrolled literatures. Then the outcome indicators were extracted and organized from the included literature, and the risk of bias was assessed by Cochrane Handbook 5.0.1.Results :A total of 10 articles were included in this study, including 739 patients. Eight articles were related to the Visual Analogue Scale (VAS) pain score, the results showed that RR = -0.29, 95% CI [-0.73, 0.15], P = 0.20; Four articles were related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, the results showed that RR = -0.15, 95% CI [-0.41,0.11], P = 0.26; Two articles were related to the Knee Injury and Osteoarthritis Outcome Score (KOOS), the results showed that RR = 0.58, 95% CI [-4.25, 5.42], P = 0.81; Three articles were related to the KOOS activities of daily living (KOOS-ADL), the results showed that RR = 0.04, 95% CI [-0.62,0.69], P = 0.91.These results indicated that the valgus knee bracing have no statistically significant in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score. Conclusion : Our current evidence suggests that valgus knee bracing may not improve pain release and function activates in KOA patients in the long-term period, but only being beneficial to the short-term rehabilitation.

show abstract

Three‐month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial

Robert-Lachaîne

Dessery

Belzile

et al. 2020

Journal Orthopaedic Research

View full text Add to dashboard Cite

Immediate biomechanical and functional effects of knee braces are often reported, however, the duration and type of knee brace treatment for knee osteoarthritis (KOA) remain unclear. The objective was to evaluate usage, comfort, pain, and knee adduction moment (KAM) of three knee braces each worn 3 months by patients. Twenty‐four patients with KOA were assigned in a randomized crossover trial a valgus three‐point bending system brace (V3P‐brace), an unloader brace with valgus and external rotation functions (VER‐brace) and a stabilizing brace used after ligament injuries (ACL‐brace). Functional questionnaires and gait assessment were carried out before and after each brace wear period of 3 months. A Friedman test was applied between brace wear diary recordings. Repeated measures analyses of variance contrasted the factors brace type (ACL, V3P, and VER), time (pre and post) and wear (without and with) on comfort, pain, function, and KAM. Brace usage was similar, but the V3P‐brace was slightly less worn. Discomfort was significantly lowered with the VER‐brace. All knee braces relieved pain and symptoms from 10% to 40%. KAM angular impulse was reduced with the three braces, but the VER‐brace obtained the lowest relative reduction of 9%. The interaction between time and wear indicated that part of the KAM reduction with brace wear was maintained post treatment. All three knee braces have great benefits for pain and function among the medial KOA population. The VER‐brace offers additional advantages on daily use, comfort and KAM, which could improve compliance to brace treatment.

show abstract

Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis

Cited by 34 publications

References 8 publications

Design Evaluation of a Novel Multicompartment Unloader Knee Brace

Design Evaluation of a Novel Multicompartment Unloader Knee Brace

Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: A meta-analysis of Randomized Trials

Three‐month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial

Contact Info

Product

Resources

About