The Effects of an Unloading Knee Brace and Insole with Subtalar Strapping for Medial Osteoarthritis of the Knee

Masataka Deie,Mitsuo Ochi,Yoshiaki Sasashige,Yuji Uchio,Nobuyuki Kumahashi,Hayatoshi Shibuya,Minoru Toriyama

doi:10.4236/ijcm.2013.412a2002

Abstract

Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA was confirmed by radiography in all patients, who were divided into three groups: exercise (n = 44), insole (n = 55), and brace (n = 19). Clinical knee functions and gait analyses were evaluated. Results: After 12 months, the clinical results for all groups had improved compared to pretreatment findings. Although the knee varus moment decreased and the gait speed increased when the insole was worn initially, the effects of the insole decreased at 6 and 12 months. In contrast, the knee varus moment decreased and the gait speed increased when the brace was initially fitted. The effects of the brace were maintained during the 12 months. Conclusions: The insole was effective for patients with Kellgren-Lawrence Grades II and III, and the knee brace was effective for patients with Grades III and IV conditions. Furthermore, the knee brace was more effective when worn for more than 6 months, while the effects of the insoles were not continuous.

Highlights

Patients with knee osteoarthritis (OA) are encountered increasingly in our aging population
Patients A total of 151 patients who were diagnosed with medial compartment OA of the knee between June 2008 and December 2009, and who agreed to this study, were enrolled
The functional knee brace used in this study was the Unloader® One (Össur, Reykjavik, Iceland; Figure 2), whichwas designed for patients with knee OA and combines a streamlined, flexible upright with a medial hinge to create two leverage points when opposing forces from the Dynamic Dual Force Straps, which cross over the knee, disperse a counter force across two lateral-aspect points of the knee

Summary

Introduction

Patients with knee osteoarthritis (OA) are encountered increasingly in our aging population. Patients with medial knee OA present varus deformities and increased mechanical stresses in the medial compartment [1,2], which together increase pain and functional disabilities [3]. Varus knee deformities cause patients to shift the lower limb axis to the medial compartment and walk with greater peak external knee adduction moment compared to individuals without knee OA [4]. The treatment for varus knee deformities can initially involve various conservative approaches such as muscle-strengthening exercises, medicines, and orthoses. A systematic review regarding the benefits of exercise for knee OA [5] revealed no definitive proof that such exercises are effective in preventing the progression of knee OA. The current guidelines for OA [6,7] indicate that musclestrengthening exercises and medicines effectively reduce knee joint pain and aid the recovery of knee joint function

Objectives

Methods

Conclusion