Biomechanical effectiveness of a distraction–rotation knee brace in medial knee osteoarthritis: Preliminary results

Laroche, Davy; Morisset, Claire; Fortunet, C.; Grémeaux, Vincent; Maillefert, Jean-Françis; Ornetti, Paul

doi:10.1016/j.knee.2014.02.015

Cited by 57 publications

(58 citation statements)

References 45 publications

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“…A total of 30 studies met inclusion criteria: seven on TENS, 6-12 six on NMES, 13-18 13 on insoles, [19][20][21][22][23][24][25][26][27][28][29][30][31] and four on bracing. [32][33][34][35] The summary characteristics of each study are displayed in Table I. TENS.…”

Section: Resultsmentioning

confidence: 99%

The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee

Cherian

Jauregui

Leichliter

et al. 2016

The Bone & Joint Journal

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The purpose of this study was to evaluate the effect of various non-operative modalities of treatment (transcutaneous electrical nerve stimulation (TENS); neuromuscular electrical stimulation (NMES); insoles and bracing) on the pain of osteoarthritis (OA) of the knee. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify the therapeutic options which are commonly adopted for the management of osteoarthritis (OA) of the knee. The outcome measurement tools used in the different studies were the visual analogue scale and The Western Ontario and McMaster Universities Arthritis Index pain index: all pain scores were converted to a 100-point scale. A total of 30 studies met our inclusion criteria: 13 on insoles, seven on TENS, six on NMES, and four on bracing. The standardised mean difference (SMD) in pain after treatment with TENS was 1.796, which represented a significant reduction in pain. The significant overall effect estimate for NMES on pain was similar to that of TENS, with a SMD of 1.924. The overall effect estimate of insoles on pain was a SMD of 0.992. The overall effect of bracing showed a significant reduction in pain of 1.34. Overall, all four non-operative modalities of treatment were found to have a significant effect on the reduction of pain in OA of the knee. This study shows that non-operative physical modalities of treatment are of benefit when treating OA of the knee. However, much of the literature reviewed evaluates studies with follow-up of less than six months: future work should aim to evaluate patients with longer follow-up.

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Section: Resultsmentioning

confidence: 99%

The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee

Cherian

Jauregui

Leichliter

et al. 2016

The Bone & Joint Journal

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“…Recently, unloader braces with a mechanism that induces valgus distraction and external rotation of the leg as the knee extends were developed. These latter braces were found to immediately reduce the terminal stance peak of knee adduction moment (KAM) by 11% to 22% in patients with medial KOA 15,16 . These two types of braces apply a valgus moment to the knee, leading to a decrease in knee adduction excursion and consequently a decrease in KAM, which is positively correlated with medial knee loading reduction 4,17,18 .…”

Section: Introductionmentioning

confidence: 99%

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

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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.

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“…However, the clinical e cacy of valgus knee bracing in the treatment of KOA is not clear. Surprisingly, different studies show opposite outcomes which seriously troubles the selections of physicians in clinic [15][16][17][18][19][20][21][22][23][24][25][26][27][30][31][32][33][34][35][36][37][38]. Therefore, a meta-analysis is urgent to be performed in order to clarify the e cacy of valgus knee bracing.…”

Section: Discussionmentioning

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

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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.

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Biomechanical effectiveness of a distraction–rotation knee brace in medial knee osteoarthritis: Preliminary results

Cited by 57 publications

References 45 publications

The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee

The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee

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

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

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