OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteo. Cartl. 27(11).
18-year-old male with patellar dislocation and fracture uses Spring Loaded knee brace as part of postoperative rehabilitation
Study performed by Dr. Ivan Wong, MD, MAcM, Dip. Sport Med. at the Division of Orthopaedic Surgery at Dalhousie University, Halifax, NS, Canada
A Spring Loaded brace aided a patient’s return to weight-bearing activity by contributing to improvements in several clinical measures.
The patient experienced pain at a 4/10 intensity only 3 times during the 5th month after surgery, which was down from the first month.
DOUBLED IKDC SCORES
After 6 months of rehabilitation using a Spring Loaded brace, the patient’s IKDC score was 100% higher than their 6-week score.
A Spring Loaded knee brace was prescribed as part of a postoperative rehabilitation plan for an active 18-year-old male who had dislocated and fractured his right patella. The Spring Loaded brace was prescribed 10 weeks following a bone graft procedure. During the interim period, the patient, Mr. BW, wore an above-knee immobilizer for 2 weeks and then a hinged knee brace for 8 weeks and for all activities, which was also coupled with physiotherapy.
When Mr. BW began wearing the Spring Loaded brace, he had minor swelling and was able to flex his leg 90 degrees. For the next 5 months, he wore the brace for 7 days per week for most daily activities.
Between his 6-week and 6-month follow-up, the patient showed substantial improvements in several clinical measures. The improvements were as follows:
- An increase in the International Knee Documentation Committee (IKDC) scores from 36.8 to 73.6.
- A decrease in pain scores. In the first month after surgery, the patient experienced pain at a 4/10 intensity 10 times per month. At 6 months, the patient experienced pain at a 3/10 intensity 3 times in the last month.
- An increase in EQ-5D, a generic quality of life metric. At 6 weeks, the patient reported moderate difficulty with usual activities and slight problems with walking and pain. At 6 months, the patient reported a perfect score, indicating a full state of health.
- An increase in the intensity of activities that could be tolerated. At 6 weeks, the patient stated walking and housework were the highest-intensity activities that could be done with no knee pain. At 6 months, the patient deemed heavy physical work or skiing as tolerable activities.
- An increase in the level of expectation surrounding a return to recreational activities. At 6 weeks, the patient was “not sure” he would be able to return to his regular activities. At 6 months, the patient rated his expectation to return as “definitely yes.”
After 11 months of rehabilitation. Mr. BW stated he felt confident enough to return to baseball with the assistance of the Spring Loaded brace once COVID-19 pandemic restrictions were lifted.
3D computed tomography of the right knee showing patellar dislocation and fracture.
Post-operative x-ray showing bone graft with screw fixation.
RELEVANCE TO SPRING LOADED BRACES
The outcomes of this case study suggest that the benefits of the Spring Loaded knee brace are not restricted to knee osteoarthritis patients, which have been the main study population of previous Spring Loaded studies 1– Bishop, E.L. et al. (2020) Osteo. Cart. Under Peer Review. 28: S243-S244
– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review.. Several clinical outcomes of this case study replicate findings of a retrospective pilot survey of Spring Loaded bracing, in which patients with knee osteoarthritis experienced reductions in knee pain and increases in knee function and quality of life scores after wearing a Spring Loaded brace for at least one month 2– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review.. In another Spring Loaded study, patients with knee osteoarthritis experienced reduced knee pain and increased support during key activities, such as walking up and down stairs 3– Bishop, E.L. et al. (2020) Osteo. Cart. Under Peer Review. 28: S243-S244, both of which are outcomes similar to Mr. BH. Based on these comparable outcomes, patients who are recovering from knee surgeries may benefit from using a Spring Loaded knee brace as part of their rehabilitation plan.
Furthermore, the Spring Loaded knee brace holds promise as a tool for postoperative rehabilitation based on its innovative design. Its novel hinge uses compact liquid springs to absorb body weight and release energy. Since the intensity of the brace’s knee extension assist can be adjusted, patients can gradually return to weight-bearing and higher intensity actions as their quadriceps’ strength improves and recovery progresses. Rehabilitation patients can also benefit from the improved stability, pain relief, and joint offloading provided by the brace4– Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1).