Research Summary

Treatment of osteoarthritis of the knee: Evidence-based guideline, 2nd edition

Jevsevar, D.S. (2013) J. Am. Acad. Orthop. Surg. 21(9): 571-6. doi: 10.5435/JAAOS-21-09-571.

Key Findings

A systematic literature review was conducted for the purpose of replacing the 2008 AAOS clinical practice guidelines, which had used evidence with methodologic issues. The updated guidelines include 15 recommendations and highlight the need for better research on the treatment of knee osteoarthritis (OA).

For patients with symptomatic OA, the updated guidelines recommended self-management programs, strengthening, and low-impact aerobic exercise as treatments. For patients with symptomatic OA and a body mass index above 25, weight loss was also a recommended treatment.

The guidelines were unable to recommend valgus bracing for patients with symptomatic knee OA due to inadequate evidence supporting its efficacy. However, recommendations state that practitioners should not avoid prescribing valgus braces solely based on the poor research quality.

Relevance to Spring Loaded Braces

Although the guidelines were unable to recommend valgus bracing due to poor research support at the time of the study, the Spring Loaded brace is unlike many OA knee braces due to its unique, evidence-supported design. As a tri-compartment offloader with a powerful knee extension assist, the Spring Loaded brace is capable of providing pain relief and functional improvements to a broad range of OA patients, including those with multicompartmental or patellofemoral knee OA 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.

Of further therapeutic importance, Spring Loaded bracing has been shown to reduce joint loads by an amount equivalent to 45 lb of weight loss 2– Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1). For many overweight or obese knee OA patients, a reduction of 45 lb is in line with the amount of weight loss associated with clinically meaningful improvements 3– Messier, S.P. et al. (2018) Arthritis Care Res. (Hobokin) 70(11): 1569–1575. As such, Spring Loaded braces may provide patients with outcomes similar to weight loss or help them achieve additional weight loss or lead a more active lifestyle through improvements to their levels of knee pain, function, and physical activity levels 4– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review..

Multiple Forces Reduced

Each TCO brace model significantly reduced PF, TF, PC ligament, PT and QT forces during a deep knee bend test.

Reduced Joint Load

Each TCO brace model significantly reduced knee joint loads by at least 32% when compared to the non-braced condition.

Replicates & Extends Previous Research

Results corroborate the knee joint offloading capabilities of a TCO, as demonstrated in a previous study (Budarick et al. 2020).

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