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Use Off-Loader Braces for Knee OA before considering surgery

A new study summarizing the evidence from peer-reviewed publications has concluded that  off-loader braces are effective in mediating pain relief resulting from knee OA and malalignment, and that bracing should be fully utilised before considering replacement surgery or joint realignment.

The authors, Dan K Ramsey and Mary E Russell from Buffalo, New York published their research in the Sept-Oct 2009 issue of Sports Health – A Multidisciplinary Approach¹. They believe that the wider use of off-loader bracing could have a positive impact on healthcare costs and the economic productivity as well as an improved quality of life for the affected individuals. Among other positive results, the pair found that during gait as well as stair stepping, bracing can:

Pain relief was confirmed to be a key benefit of wearing off-loader braces which may result from reduced muscle co-contractions, as mediated by the brace which mechanically stabilizes the knee. Pain relief may also be mediated by distracting the involved compartment via external varus or valgus forces applied to the knee. This in turn improves tibiofemoral alignment, shifting the load off the degenerative compartment and thus reducing potentially damaging and provocative mechanical stresses.

Off-loader braces given high ratings by both OARSI and SORT for use by knee OA patients

The authors’ conclusions reflect the latest OARSI recommendations awarding the use of off-loader braces for unicompartmental knee OA a recommendation score of 76% (95% confidence interval, 69% - 83%) for their efficacy, safety and cost-effectiveness. OA bracing was also given the highest ‘SORT’ (Strength of Recommendation Taxonomy) grade for reducing knee-pain, improving stability and diminishing the risk of falling.

Read more about the new DonJoy OA Assist brace here.

¹ Unloader Braces for Medial Compartment Knee Osteoarthritis: Implications on Mediating Progression:
Dan K. Ramsey, Mary E. Russell: Sports Health - A Multidisciplinary Approach, Sept/Oct 2009 Volume 1, No. 5, pp. 416-426

 

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