Abstract:

Knee osteoarthritis (OA) is increasing in the United States, and some have proposed the use of unloader bracing as an adjunct to current standard treatments. Our purpose was to evaluate outcomes of this brace for the treatment of knee osteoarthritis compared with standard non-operative treatment. Specifically, we evaluated: (1) pain relief, (2) objective functional improvement, (3) subjective functional improvement, (4) quality of life, (5) isokinetic quadriceps muscle strength, and (6) gait changes. A prospective, randomized, study was performed on 18 patients who had Kellgren-Lawrence grade 1 and 2 osteoarthritis. Patients were randomized to receive either standard treatment or an unloader brace. End points evaluated included: functional tests, Knee Society Score, Short Form 36 (SF-36) health survey, Visual Analog Scale (VAS) for pain, Lower Extremity Functional Scale, isokinetic quadriceps and hamstring muscle strength, and 3-dimensional gait analysis. There were no differences between cohorts in evaluation of pain (VAS), objective functional tests, subjective functional outcomes (Knee Society Scores and LEFS), quality of life assessment with SF-36, isokinetic quadriceps and hamstring muscle strength, and gait parameters. The use of unloader brace demonstrated similar improvements compared with standard treatments for knee osteoarthritis, and we believe that it can be a beneficial or equivalent adjunct to continuum of care for the treatment for knee osteoarthritis.

Authors:

Michael A. Mont, MD, Director, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, Jeffrey J. Cherian, DO, Research Fellow, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, Anil Bhave, PT, Director of Department of Physical Therapy, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, Roland Starr, MS, Director of Gait Lab, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland , Randa K. Elmallah, MD, Research Fellow, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, Walter B. Beaver, Jr., MD, Medical Director, OrthoCarolina, Charlotte, North Carolina, Steven F. Harwin, MD, FACS, Director, Center of Reconstructive Joint Surgery, Beth Israel Medical Center, New York, New York

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