Unloader Knee Brace Increases Medial Compartment Joint Space During Gait in Knee Osteoarthritis Patients

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2018 Nov 3

PMID 30386999

Citations 3

Authors

Kanto Nagai

Shumeng Yang

Freddie H Fu

William Anderst

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of the present study was to investigate the effect of the unloader brace on medial compartment dynamic joint space (DJS) during gait, while simultaneously recording ground reaction force (GRF) in varus knee osteoarthritis (OA) patients using a highly accurate biplane radiography system which allowed continuous measurement of DJS from heel strike through the midstance phase of gait. The hypothesis was that DJS in the medial compartment would be greater with the unloader brace than without the brace during gait.

Methods: After 2 weeks of daily use of the unloader brace, ten varus knee OA patients (age 52 ± 8 years) walked with and without the brace on an instrumented treadmill, while biplane radiographs of the OA knees were acquired at 100 Hz. Medial compartment DJS was determined from heel strike to terminal stance (0-40% of the gait cycle) using a validated volumetric model-based tracking process that matches subject-specific 3D bone models to the biplane radiographs. The GRF during gait was collected at 1000 Hz. Repeated-measures ANOVA was used to explore differences in medial compartment DJS and GRF between the unbraced and braced conditions. A patient-reported subjective questionnaire related to the brace use was collected at the time of the test.

Results: Medial compartment DJS was significantly greater with the unloader brace than without the brace during gait (P = 0.005). The average difference was 0.3 mm (95% confidence interval 0.1-0.4 mm). No significant difference was observed in terms of vertical GRF between the two conditions. The questionnaire showed participants felt reduced pain when wearing the brace.

Conclusion: The unloader brace has the significant effect of increasing medial compartment DJS during gait, which supports the underlying premise that the unloader brace reduces pain by increasing medial joint space during dynamic loading activities.

Level Of Evidence: III.

Citing Articles

Evidence-Based Review of Nonsurgical Treatments for Knee and Hip Osteoarthritis.

Misra D, Felson D Eur J Rheumatol. 2024; .

PMID: 38705970 PMC: 11184962. DOI: 10.5152/eurjrheum.2024.22096.

EFFECTS OF A SEMI-RIGID KNEE BRACE ON MOBILITY AND PAIN IN PEOPLE WITH KNEE OSTEOARTHRITIS.

Dries T, Windt J, Akkerman W, Kluijtmans M, Janssen R J Rehabil Med Clin Commun. 2022; 5:2483.

PMID: 35859691 PMC: 9274778. DOI: 10.2340/jrmcc.v5.2483.

Biomechanical Effect of Valgus Knee Braces on the Treatment of Medial Gonarthrosis: A Systematic Review.

Yan Y, Liu G, Zhang L, Gong R, Fu P, Han B Appl Bionics Biomech. 2022; 2022:4194472.

PMID: 35677195 PMC: 9168205. DOI: 10.1155/2022/4194472.

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