Non-operative treatment of unicompartmental osteoarthritis of the knee: a prospective randomized trial with two different braces-ankle-foot orthosis versus knee unloader brace.


Journal

Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 30 03 2018
pubmed: 27 9 2018
medline: 4 4 2019
entrez: 27 9 2018
Statut: ppublish

Résumé

The use of an unloader brace is a non-surgical treatment option for patients with medial osteoarthritis (OA). However, many patients do not adhere to brace treatment, because of skin irritation due to the pads at the level of the joint space and bad fit. A new concept to unload the medial compartment of the knee is a foot ankle brace with a lever arm pressing the thigh in valgus. The aim of this prospective randomized trial was to examine the outcomes of patients with medial OA after treatment with a conventional knee unloader brace (Unloader One For this multicenter trial, 160 patients (> 35 years) with medial OA were randomly allocated to treatment with a conventional knee unloader brace (Unloader One In both groups, walking pain improved between T0 and T1 and also between T0 and T2 without a significant group difference. For pain at sports, both groups showed a significant improvement between T0 and T2 without a significant group difference. The KOOS subscales symptoms, pain, activity, sport, and quality of life increased significantly in both treatment groups without any significant group differences at T 0, T1, and T2. There was also no significant group difference in additional interventions and weekly or daily brace use. In the Agilium FreeStep The results of this clinical trial show that the foot ankle brace is as effective as a conventional knee unloader brace for the treatment of medial knee OA with regard to clinical outcome. The rate of side effects such as bruises was significantly lower in the Agilium FreeStep DRKS00009215, 13.8.2015.

Sections du résumé

BACKGROUND BACKGROUND
The use of an unloader brace is a non-surgical treatment option for patients with medial osteoarthritis (OA). However, many patients do not adhere to brace treatment, because of skin irritation due to the pads at the level of the joint space and bad fit. A new concept to unload the medial compartment of the knee is a foot ankle brace with a lever arm pressing the thigh in valgus. The aim of this prospective randomized trial was to examine the outcomes of patients with medial OA after treatment with a conventional knee unloader brace (Unloader One
METHODS METHODS
For this multicenter trial, 160 patients (> 35 years) with medial OA were randomly allocated to treatment with a conventional knee unloader brace (Unloader One
RESULTS RESULTS
In both groups, walking pain improved between T0 and T1 and also between T0 and T2 without a significant group difference. For pain at sports, both groups showed a significant improvement between T0 and T2 without a significant group difference. The KOOS subscales symptoms, pain, activity, sport, and quality of life increased significantly in both treatment groups without any significant group differences at T 0, T1, and T2. There was also no significant group difference in additional interventions and weekly or daily brace use. In the Agilium FreeStep
DISCUSSION CONCLUSIONS
The results of this clinical trial show that the foot ankle brace is as effective as a conventional knee unloader brace for the treatment of medial knee OA with regard to clinical outcome. The rate of side effects such as bruises was significantly lower in the Agilium FreeStep
TRIAL REGISTRATION BACKGROUND
DRKS00009215, 13.8.2015.

Identifiants

pubmed: 30255369
doi: 10.1007/s00402-018-3040-8
pii: 10.1007/s00402-018-3040-8
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

155-166

Auteurs

Wolf Petersen (W)

Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Grunewald, Caspar Theyß Strasse 27-31, 14193, Berlin, Germany. wolf.petersen@pgdiakonie.de.

Andree Ellermann (A)

Arcus Sportklinik, Rastatter Straße 17, 75179, Pforzheim, Germany.

Jörg Henning (J)

Krankenhaus Lahnhöhe, Zentr. für konserv. Orthopädie, Am Kurpark 1, 56112, Lahnstein, Germany.

Stefan Nehrer (S)

Donau Universität Krems, Dr. Karl Dorrek Straße 30, 3500, Krems, Austria.

Ingo Volker Rembitzki (IV)

Deutsche Sporthochschule Köln, Cologne, Germany.

Jürgen Fritz (J)

Orthopädisch Chirurgisches Centrum Tübingen, Wilhelmstr. 134, 72074, Tübingen, Germany.

Christoph Becher (C)

Orthopädische Klinik der MH Hannover, Anna-von-Borries-Straße 1-7, 30625, Hannover-Kleefeld, Germany.

Alfio Albasini (A)

FISIOTERAPIA Albasini and Müller, Viale Giuseppe Motta 15, 6500, Bellinzona, Switzerland.

Wolfgang Zinser (W)

St. Vinzenz Hospital-Dinslaken, Dr. Otto-Seidel Str. 31, 46535, Dinslaken, Germany.

Volker Laute (V)

Gelenk und Wirbelsäulenzentrum, Kieler Str. 1, 12163, Berlin, Germany.

Klaus Ruhnau (K)

Gemeinschaftspraxis Rosenthal and Schubert, Viktoriastr. 66-70, 44787, Bochum, Germany.

Hartmut Stinus (H)

Orthopaedicum Northeim, Sturmbäume 3, 37154, Northeim, Germany.

Christian Liebau (C)

Asklepios Harzklinik Fritz-König-Stift, Ilsenburger Straße 95, 38667, Bad Harzburg, Germany.

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Classifications MeSH