INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.

INTRODUCTION Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.

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El éxito del tratamiento de la displasia de caderas consiste en lograr una reducción concéntrica y evitar la displasia residual. Uno de los factores esenciales es el diagnóstico y tratamiento precoz. Objetivo: evaluar la relación entre la edad de inicio de tratamiento de displasia de caderas y la presencia de displasia residual al año de edad. Pacientes y Método: Estudio pronóstico retrospectivo. Se seleccionaron pacientes con displasia de cadera tratados con correas de Pavlik en un centro terciario. Se definió displasia residual como un índice acetabular mayor a 28 grados al año de edad. Se determinó asociación de displasia residual con edad de inicio de tratamiento, bilateralidad e índice acetabular mayor a 36 grados. Se utilizaron las pruebas de T-Student, ChiCuadrado e índice de Youden. Se consideró significativo un valor-p < 0,05. Se utilizó el programa STATA v.16. Resultados: Se incluyeron 153 pacientes (262 caderas), 84,3% (129) mujeres, 71,2% (109) con displasia bilateral. Cincuenta y nueve caderas (22,52%) presentaron displasia residual, encontrándose asociación significativa con la edad de inicio de tratamiento (p = 0,03), displasia bilateral (p < 0,01) e índice acetabular mayor a 36 grados (p = 0,01). La edad de inicio posterior a los 4.5 meses aumentó el riesgo de displasia residual en 2.5 veces. (IC95% 1,25-5,03) Conclusión: Se observó aumento de la displasia residual en inicio de tratamiento mayor a 4,5 meses. Es relevante considerar este resultado en las guías clínicas locales para lograr un diagnóstico y tratamiento exitosos.