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RESEARCH PRODUCT

Biomechanical effectiveness of a distraction-rotation knee brace in medial knee osteoarthritis: preliminary results.

Clémentine FortunetVincent GremeauxClaire MorissetPaul OrnettiPaul OrnettiJean-francis MaillefertJean-francis MaillefertDavy Laroche

subject

musculoskeletal diseasesMalemedicine.medical_specialtyWOMACVisual Analog ScaleOsteoarthritisPhysical medicine and rehabilitationmedicineHumansOrthopedics and Sports MedicineProspective StudiesGaitBracesbiologybusiness.industryEquipment DesignMiddle AgedOsteoarthritis Kneemusculoskeletal systembiology.organism_classificationmedicine.diseaseGaitBraceBiomechanical PhenomenaPreferred walking speedValgusmedicine.anatomical_structurePatient SatisfactionGait analysisFemaleAnklebusinesshuman activitiesLocomotion

description

Abstract Background Non-pharmacological therapies are recommended for the care of knee osteoarthritis patients. Unloader knee braces provide an interesting functional approach, which aims to modulate mechanical stress on the symptomatic joint compartment. We aimed to confirm the biomechanical effects and evaluate functional benefits of a new knee brace that combines a valgus effect with knee and tibial external rotation during gait in medial osteoarthritis patients. Methods Twenty patients with unilateral symptomatic medial knee osteoarthritis were included and they performed two test sessions of 3D gait analysis with and without the brace at the initial evaluation (W0) and after 5weeks (W5) of wearing the brace. VAS-pain, satisfaction scores, WOMAC scores, spatio-temporal gait parameters (gait speed, stride length, stance and double stance phases, step width), and biomechanical data of the ipsilateral lower limb (hip, knee, ankle and foot progression angles) were recorded at each session. Results VAS-pain and WOMAC significantly decreased at W5. Walking speed was not significantly modified by knee bracing at W0, but increased significantly at W5. Knee adduction moments and foot progression angles significantly decreased in the terminal stance and push off, respectively, with bracing at W0 and W5. Lower-limb joint angles, moments and powers were significantly modified by wearing the brace at W0 and W5. Conclusion This new knee brace with distraction–rotation effects significantly alters knee adduction moments and foot progression angles during gait, which might lead to significant functional gait improvements and have carry-over effects on pain at the short term in osteoarthritis patients ( Level of Evidence: level IV.

10.1016/j.knee.2014.02.015https://pubmed.ncbi.nlm.nih.gov/24642050