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Functional Knee Bracing for Medial Compartment Osteoarthritis: A Review. Dennis Ng
Objective: To review the current research evaluating the effectiveness of functional knee braces designed for use in patients with medial knee compartment osteoarthritis in association with a varus deformity (varus gonarthrosis). Data Sources: Nine studies published in peer reviewed journals and listed in the Medline database were reviewed. Study Selection: Studies which followed patients with varus gonarthrosis using a brace, or compared braced and non-braced performances during functional and laboratory tests were evaluated. Data Synthesis: Functional tests analysed included: walking, climbing up and down stairs, activities of daily living and standing balance. Specific measurements used in laboratory and subjective tests included: VAS scales, walking distances, walking times, x-ray findings, isokinetic quadriceps muscle strength, proprioception, changes in mean adduction moments, condylar separation distance and angles, and shank segment alignment with respect to thigh segment. Studies reported significant improvements in most areas with the exception of changes in proprioception and mean adduction moment where results were conflicting. As well, bracing was not effective in improving time and distances for walking. Conclusion: Bracing appears to be a favourable conservative treatment for decreasing pain in patients with varus gonarthrosis. Clinical Relevance: This conservative treatment approach may benefit osteoarthritic patients in that it could delay surgical intervention in patients who may otherwise require total knee arthroplasty to treat their symptoms