A comparison of the biomechanical effects of valgus knee braces and lateral wedged insoles in patients with knee osteoarthritis

Jones, Richard; Nester, Christopher; Richards, Jim; Kim, Winston Y.; Johnson, David S.; Jari, S.; Laxton, Philip; Tyson, Sarah

doi:10.1016/j.gaitpost.2012.08.002

Cited by 98 publications

(167 citation statements)

References 26 publications

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“…Data from 445 patients that met the American College of Rheu- (42,43,46). Two studies (n ϭ 191 subjects) compared a valgus knee brace group and a control group that did not use an orthosis (41,44).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (n ϭ 191 subjects) compared a valgus knee brace group and a control group that did not use an orthosis (41,44). Five studies (n ϭ 295 subjects) compared a valgus knee brace group and a control group that used a control orthosis (neutral knee brace, neoprene knee sleeve, or shoe insert) (41)(42)(43)45,46). One study had 3 treatment groups and was included in both of the additional analyses (41).…”

Section: Resultsmentioning

confidence: 99%

“…Instructions varied widely and included wearing the brace all day (40), only during activity (41)(42)(43), as needed (45), or a minimum of 4 hours per day (46). One article indicated that a technician or therapist fit the brace and gave patients donning and doffing instructions, but did not specify type or frequency of use (44).…”

Section: Resultsmentioning

confidence: 99%

“…use at the longest followup period, ranging from 45-58% and 71-100% of patients, respectively (39,(42)(43)(44)(45)(46). Three articles reported complications experienced by patients (44 -46).…”

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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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“…The 18 eligible studies included a total of 534 participants. All but 4 studies were withinsubjects repeated-measures designs, with the remaining being randomized trials (30)(31)(32)(33). Four studies reported the use of the ACR criteria (31,(34)(35)(36), with 10 stating cutoffs regarding the severity of knee pain (13,14,21,31,32,34,(36)(37)(38)(39), most commonly .3 of 10 on a visual analog scale (13,14,21,31,32,34,37).…”

mentioning

confidence: 99%

Lateral Wedge Insoles for Reducing Biomechanical Risk Factors for Medial Knee Osteoarthritis Progression: A Systematic Review and Meta‐Analysis

Arnold

Wong

Jones

et al. 2016

Arthritis Care & Research

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Objective. Lateral wedge insoles are intended to reduce biomechanical risk factors of medial knee osteoarthritis (OA) progression, such as increased knee joint load; however, there has been no definitive consensus on this topic. The aim of this systematic review and meta-analysis was to establish the within-subject effects of lateral wedge insoles on knee joint load in people with medial knee OA during walking. Methods. Six databases were searched from inception until February 13, 2015. Included studies reported on the immediate biomechanical effects of lateral wedge insoles during walking in people with medial knee OA. Primary outcomes of interest relating to the biomechanical risk of disease progression were the first and second peak external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI). Eligible studies were pooled using random-effects metaanalysis.Results. Eighteen studies were included with a total of 534 participants. Lateral wedge insoles resulted in a small but statistically significant reduction in the first peak EKAM (standardized mean difference [SMD] 20.19; 95% confidence interval [95% CI] 20.23, 20.15) and second peak EKAM (SMD 20.25; 95% CI 20.32, 20.19) with a low level of heterogeneity (I 2 5 5% and 30%, respectively). There was a favorable but small reduction in the KAAI with lateral wedge insoles (SMD 20.14; 95% CI 20.21, 20.07, I 2 5 31%). Risk of methodologic bias scores (quality index) ranged from 8 to 13 out of 16. Conclusion. Lateral wedge insoles cause small reductions in the EKAM and KAAI during walking in people with medial knee OA. Current evidence demonstrates that lateral wedge insoles appear ineffective at attenuating structural changes in people with medial knee OA as a whole and may be better suited to targeted use in biomechanical phenotypes associated with larger reductions in knee load.

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