Surgeons could confidently prescribe unloader knee brace to OA patients as it significantly improved function by enhancing the medial compartment dynamic joint space during gait.
The research undertaken in the University of Pittsburgh and University Graduate School of Medicine Kobe explains that unloader brace enhances the medial compartment dynamic joint space (DJS) during gait and helps to reduce pain.
The study conducted by Kanto Nagai et al. assessed the impact of the unloader brace on medial compartment DJS during gait, whereas concurrently measuring ground reaction force (GRF) in varus knee OA subjects applying a highly accurate biplane radiography system which enabled continuous estimation of DJS from heel strike within the midstance phase of gait. The study hypothesized that with unloader brace, the medial compartment DJS would be higher than without the brace during gait.
Ten varus knee OA patients walked with and without the brace on an instrumented treadmill, and biplane radiographs of the OA knees were obtained at 100 Hz following daily use of the unloader brace for two weeks. Further, a validated volumetric model-based tracking process was used to determine medial compartment DJS from heel strike to the terminal stance, which meets subject-specific 3D bone models to the biplane radiographs.
The GRF at the time of gait was obtained at 1000 Hz. The difference in the medial compartment DJS and GRF during the braced and unbraced circumstances was measured using the repeated-measures ANOVA. The patient-reported subjective questionnaire associated with the brace use was obtained during the test.
Subjects with the
unloader brace exhibited higher medial compartment DJS as compared to that of
without the brace during gait. The mean difference noticed was 0.3 mm. No
considerable diversity was observed regarding vertical GRF among the two
conditions. As per the questionnaire, participants felt less pain when wearing
the brace. This explains that the unloader knee brace has a significant role in
reducing pain among osteoarthritis patients.
Knee Surgery, Sports Traumatology, Arthroscopy
Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients
Kanto Nagai et al.
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