Article

Valgus bracing in medial knee osteoarthritis aims to improve gait
function by reducing the loading of the medial compartment. Orthosis composition
and optimal adjustment is essential to achieve biomechanical and clinical
effectiveness. OBJECTIVES:
To investigate biomechanical functionality during
gait, pain relief and compliance in patients with knee osteoarthritis using a
lightweight adjustable knee unloader orthosis. STUDY DESIGN: Prospective
observational clinical trial. METHODS: Instrumented gait analysis in 22 patients
with unilateral medial knee osteoarthritis was performed after a 2-week orthosis
acclimatisation period. Kinematics and kinetics during gait as well as force
transmission from the orthosis to the knee were analysed. Measurements were
performed without, at individualised and at reduced orthosis setting. The
assessment was supplemented by patient-related pain sensation and compliance
questionnaires. RESULTS: Orthosis wear significantly reduced the knee adduction
moment by up to 20% depending on orthosis adjustment, whereas pain sensation was
significantly reduced by 16%. A significant positive correlation was found
between force transmissions and knee adduction moment as well as for frontal knee
angle. Compliance was good with a main daily use of 2-6 h. CONCLUSION: The
orthosis provides significant biomechanical improvements, pain relief and good
patient compliance. Patients had a biomechanical benefit for the individualised
and reduced orthosis adjustments. Clinical relevance In patients with medial knee
osteoarthritis, a lightweight medial unloader orthosis effectively reduced
external knee adduction moment and pain sensation during daily activities. Thus,
use of lightweight orthoses effectively supports conservative treatment in medial
knee osteoarthritis.

Langue : ANGLAIS