A comparison of knee braces during walking for the treatment of osteoarthritis of the medial compartment of the knee

Richards, Jim; Sanchez-Ballester, Jordi; Jones, Richard; Darke, N.; Livingstone, Brian

doi:10.1302/0301-620x.87b7.16005

Cited by 90 publications

(82 citation statements)

References 13 publications

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“…One RCT compared 2 different types of valgus knee braces (custom-fit versus off-the-shelf) and was excluded from the meta-analysis (39). Another RCT provided insufficient pain and function data for inclusion in the meta-analysis (40). Both RCTs were included in the description of instructions, complications, and compliance ( Figure 1).…”

Section: Resultsmentioning

confidence: 99%

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Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Moyer

Birmingham

Bryant

et al. 2015

Arthritis Care & Research

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Objective. To evaluate the effects of valgus knee bracing on pain and function, and compliance and complications, in patients with medial knee osteoarthritis (OA). Methods. A meta-analysis of randomized controlled trials that compared changes in patient-reported pain and/or function in patients with medial knee OA was performed. Seven databases were searched from their inception to January 2014. Two reviewers independently determined study eligibility, rated risk of bias, and extracted data. Pooled estimates and 95% confidence intervals (95% CIs) for standardized mean differences (SMDs) for the improvement in pain (and function) were calculated. Event rates (proportions) were calculated for studies that reported complications.

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Section: Resultsmentioning

confidence: 99%

“…ported the brace to be bulky, but did not include the number of patients; therefore, an event rate could not be calculated (40).…”

Section: Resultsmentioning

confidence: 99%

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Moyer

Birmingham

Bryant

et al. 2015

Arthritis Care & Research

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“…Correction of malalignment was evaluated with a standardized standing whole-leg radiograph. Although both groups (valgus brace and wedged insole) had improved patient-reported outcomes, no significant change in alignment was seen on this static evaluation [26], so whether a brace or insole corrects malalignment in the frontal plane remains controversial [8,15,21,23,26].…”

Section: Introductionmentioning

confidence: 86%

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Duivenvoorden¹,

Raaij

Horemans³

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background The results of conservative treatment of knee osteoarthritis (OA) are generally evaluated in epidemiological studies with clinical outcome measures as primary outcomes. Biomechanical evaluation of orthoses shows that there are potentially beneficial biomechanical changes to joint loading; however, evaluation in relation to clinical outcome measures in longitudinal studies is needed. Questions/purposes We asked (1) is there an immediate effect on gait in patients using a laterally wedged insole or valgus knee brace; (2) is there a late (6 weeks) effect; and (3) is there a difference between subgroups within each group with respect to patient compliance, body mass index, and OA status? Methods This was a secondary analysis of data from a previous randomized controlled trial of patients with early medial knee OA. A total of 91 patients were enrolled in that trial, and 73 (80%) completed it after 6 months. Of the enrolled patients, 80 (88%) met prespecified inclusion criteria for analysis in the present study. The patients were randomized to an insole or brace. Gait was analyzed with and without wearing the orthosis (insole or brace) at baseline and after 6 weeks. Measurements were taken of the knee adduction moment, ground reaction force, moment arm, walking speed, and toe-out angle. Data were analyzed with regression analyses based on an intention-to-treat principle. Results A mean reduction of 4% (± 10) (95% confidence interval [CI], À0.147 to À0.03, p = 0.003) of the peak knee adduction moment and 4% (± 13) (95% CI, À0.009 to À0.001, p = 0.01) of the moment arm at baseline was observed in the insole group when walking with an insole was compared with walking without an insole. A mean reduction of 1% (± 10) (95% CI, À0.002 to À0.001, p = 0.001) of the peak knee adduction moment and no reduction of the moment arm were measured after 6 weeks.

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“…This can be treated conservatively with various unloading braces for the knee. 2,3 However, the compliance with these devices can be problematic due to the fact that they are perceived as being cumbersome to implement on a daily basis. 4 Another effective and economical treatment option for medial knee OA is the laterally wedged foot orthotic device.…”

Section: Introductionmentioning

confidence: 99%

Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis

Butler¹,

Barrios²,

Royer

et al. 2009

Prosthetics &Amp; Orthotics International

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The purpose of this study was to examine the effects of laterally wedged foot orthotic devices, used to treat knee osteoarthritis, on frontal plane mechanics at the rearfoot and hip during walking. Thirty individuals with diagnosed medial knee osteoarthritis were recruited for this study. Three dimensional kinematics and kinetics were recorded as the subjects walked in the laboratory at an intentional walking speed. Peak eversion, eversion excursion and peak eversion moment were increased while the peak knee adduction moment was reduced in the laterally wedged orthotic condition compared to the no wedge condition. In contrast, no changes were observed in the variables of interest at the hip. There was no significant relationship between the change in the peak frontal plane moment at the rearfoot and change in the peak frontal plane moment at the knee or hip as a result of the lateral wedge. Laterally wedged foot orthotic devices, used to treat knee osteoarthritis, do not influence hip mechanics. However, they do result in increased rearfoot eversion and inversion moment. Therefore, a full medical screen of the foot should occur before laterally wedged foot orthotic devices are prescribed as a treatment for knee osteoarthritis.

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A comparison of knee braces during walking for the treatment of osteoarthritis of the medial compartment of the knee

Cited by 90 publications

References 13 publications

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis

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