RSS-Feed abonnieren
DOI: 10.1055/s-0036-1593616
Clinical Outcomes of a Pneumatic Unloader Brace for Kellgren–Lawrence Grades 3 to 4 Osteoarthritis: A Minimum 1-Year Follow-Up Study
Publikationsverlauf
29. Juli 2016
28. August 2016
Publikationsdatum:
17. Oktober 2016 (online)
![](https://www.thieme-connect.de/media/jks/201608/lookinside/thumbnails/10-1055-s-0036-1593616_16jul13ssa-1.jpg)
Abstract
The use of a pneumatic unloader brace has been shown in pilot studies to decrease pain and increase muscle strength in patients with knee osteoarthritis (OA). Therefore, we analyzed patients who had knee OA, and either received a pneumatic unloader brace and conventional treatment or conventional treatment alone. Specifically, we assessed: (1) use of pain relieving injections; (2) opioid consumption; and (3) the eventual need for total knee arthroplasty (TKA) in the above-mentioned cohort. We performed an analysis of a longitudinally maintained database of patients from a prospective, randomized, single center study. This study randomized patients who had Kellgren–Lawrence grades 3 to 4 to receive either a pneumatic unloader brace and conventional treatment or conventional treatment alone. The brace cohort comprised 11 patients with a mean age of 55 years (range, 37–70 years). The final matched cohort comprised 25 patients with a mean age of 63 years (range, 41–86 years). The minimum follow-up was 1 year. There was a lower proportion of patients who underwent an eventual TKA in the bracing cohort as compared with the nonbracing cohort (18 vs. 36%). The mean time to TKA was longer in the bracing cohort as compared with the nonbracing cohort (482 vs. 389 days). The proportion of patients who used opioids was similar in both groups (27 vs. 22%). There was a significantly lower number of patients who received injections in the bracing cohort as compared with the nonbracing cohort (46 vs. 83%, p = 0.026). The bracing cohort had received a significantly lower number of injections and a lower rate of subsequent TKA as compared with the nonbracing cohort. The mean time to TKA was also longer among the bracing cohort. These results may demonstrate the potential of this brace to reduce the need for and prolonging the time to TKA. Performing larger prospective randomized studies, with built-in compliance monitors is warranted. This brace may be a valuable adjunct to the current knee OA treatment armamentarium pending further investigation.
-
References
- 1 Prevention, C.f.D.C.a. Osteoarthritis (OA). 2015 Available at: http://www.cdc.gov/arthritis/basics/osteoarthritis.htm . Accessed April 13, 2016
- 2 Neogi T, Zhang Y. Epidemiology of osteoarthritis. Rheum Dis Clin North Am 2013; 39 (1) 1-19
- 3 Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ 2011; 342: d1165
- 4 Chen A, Gupte C, Akhtar K, Smith P, Cobb J. The global economic cost of osteoarthritis: how the UK compares. Arthritis (Egypt) 2012; 2012: 698709
- 5 Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16 (4) 494-502
- 6 Johnson AJ, Starr R, Kapadia BH, Bhave A, Mont MA. Gait and clinical improvements with a novel knee brace for knee OA. J Knee Surg 2013; 26 (3) 173-178
- 7 Cherian JJ, Bhave A, Kapadia BH, Starr R, McElroy MJ, Mont MA. Strength and functional improvement using pneumatic brace with extension assist for end-stage knee osteoarthritis: a prospective, randomized trial. J Arthroplasty 2015; 30 (5) 747-753
- 8 Selman JP, de Camargo AA, Santos J, Lanza FC, Dal Corso S. Reference equation for the 2-minute walk test in adults and the elderly. Respir Care 2014; 59 (4) 525-530
- 9 Laroche D, Morisset C, Fortunet C, Gremeaux V, Maillefert JF, Ornetti P. Biomechanical effectiveness of a distraction-rotation knee brace in medial knee osteoarthritis: preliminary results. Knee 2014; 21 (3) 710-716
- 10 Komistek RD, Dennis DA, Northcut EJ, Wood A, Parker AW, Traina SM. An in vivo analysis of the effectiveness of the osteoarthritic knee brace during heel-strike of gait. J Arthroplasty 1999; 14 (6) 738-742
- 11 Brouwer RW, van Raaij TM, Verhaar JA, Coene LN, Bierma-Zeinstra SM. Brace treatment for osteoarthritis of the knee: a prospective randomized multi-centre trial. Osteoarthritis Cartilage 2006; 14 (8) 777-783
- 12 Kirkley A, Webster-Bogaert S, Litchfield R , et al. The effect of bracing on varus gonarthrosis. J Bone Joint Surg Am 1999; 81 (4) 539-548
- 13 Dessery Y, Belzile EL, Turmel S, Corbeil P. Comparison of three knee braces in the treatment of medial knee osteoarthritis. Knee 2014; 21 (6) 1107-1114
- 14 Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg 2013; 21 (9) 571-576