Effectiveness of Valgus Offloading Knee Braces in the Treatment of Medial Compartment Knee Osteoarthritis: A Systematic Review

Gohal, Chetan; Shanmugaraj, Ajaykumar; Tate, Patrick; Horner, Nolan S.; Bedi, Asheesh; Adili, Anthony; Khan, Moin

doi:10.1177/1941738118763913

Cited by 35 publications

(33 citation statements)

References 60 publications

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“…Duivenvoorden et al [36] further con rmed the conclusions of this study. They conducted a secondary analysis of randomized controlled trial data in 80 patients with KOA, and found no biomechanical evidences to support the use of valgus knee bracing.…”

Section: Discussionsupporting

confidence: 85%

“…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%

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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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Section: Discussionsupporting

confidence: 85%

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

View full text Add to dashboard Cite

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“…al suggested a correlation between joint realignment and clinical improvement [37]. However, it was noted that most previous studies concentrated on the clinical effects of valgus bracing in patients with medial knee OA [6,[14][15][16][17]19,38].…”

Section: Plos Onementioning

confidence: 99%

“…A detailed outstanding overview of the current scientific progress and standing can be found in e.g. [2,7,8,15,19]. Studies on knee kinematics have allowed for in-depth analysis of restrictions in movement caused by the brace, improving comprehension of secondary problems, and overall wearability.…”

Section: Introductionmentioning

confidence: 99%

The effect of a knee brace in dynamic motion—An instrumented gait analysis

et al. 2020

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Background Osteoarthritis (OA) is a common problem in the older population. To reduce pain and stress in the affected knee joint compartment, a functional knee brace is often prescribed by physicians to protect it from high loads. Objectives An instrumented gait analysis should evaluate how the 4-point knee orthosis for varus or valgus load relief (M.4s OA) changes the kinematics of the knee, especially in the frontal plane. Methods 17 healthy participants took part and were analyzed with an inertial sensor system (MyoMotion) giving continuous, objective information on the anatomical angles. The measurements were made both without wearing a knee brace and with the brace in different settings. Results The results show a significant reduction in the maximum knee abduction and raised knee adduction. The knee brace, with a strong adjustment in varus or valgus orientation, caused a shift of maximum ab-/adduction in the proposed direction in 69% and 75% of the dynamic tests, respectively. The knee motion in the frontal plane shows individual movement patterns.

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“…Nonpharmacological and nonsurgical interventions can reduce pain and improve physical function in patients with knee OA [7]. Some previous studies show the effectiveness of some interventions such as traditional Chinese medicine (auriculotherapy, acupuncture) and whole body vibration [8], orthotic devises [9], and electrical stimulation [10]. In addition, a systematic review of guidelines for the management of osteoarthritis proposes that exercise is a key factor for treating OA [11].…”

Section: Introductionmentioning

confidence: 99%

Effect of Tai Chi Training on Plantar Loads during Walking in Individuals with Knee Osteoarthritis

Zhang

Huang

Liu

et al. 2020

BioMed Research International

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Tai Chi is an available method for the treatment of knee osteoarthritis (KOA). The impacts of Tai Chi on plantar loads of individuals with KOA are not fully understood. 46 participants with knee osteoarthritis were randomly assigned into the Tai Chi group (n=23) or the control group (n=23). The Tai Chi group attended a 6-month Tai Chi program, and the control group participated in a wellness education program. Novel Pedar-X system was used to collect the peak pressure (PP) and maximum force (MF) during walking before and 6 months after the intervention. Significant higher peak pressure and maximum force were observed in the 4th and 5th metatarsophalangeal joints in the Tai Chi group. However, there were significant declines in the peak pressure of the whole foot and the 2nd and 3rd metatarsophalangeal joints and maximum force of the heel in the control group. These results suggested that individuals with KOA might change the pattern of plantar loads during walking through Tai Chi, and plantar loads would be useful as a parameter to assess the effect of Tai Chi on knee osteoarthritis. This trial is registered with Clinical Trials: CHiCTR-TRC-13003264.

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Effectiveness of Valgus Offloading Knee Braces in the Treatment of Medial Compartment Knee Osteoarthritis: A Systematic Review

Cited by 35 publications

References 60 publications

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

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

The effect of a knee brace in dynamic motion—An instrumented gait analysis

Effect of Tai Chi Training on Plantar Loads during Walking in Individuals with Knee Osteoarthritis

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