Long-term compliance data raise issues.
A study published in the August issue of Orthopedics found that although unloader braces effectively relieve pain and improve function in patients with unicompartmental knee osteoarthritis, many patients stop wearing the devices after a few years and opt for total knee replacement.
By Emily Delzell Lower Extremity Review September 2011
Experts who reviewed this study for Lower Extremity Review and work with these patients in clinical settings said it brings up two important points. First, the need to help patients get the best-fitting brace possible, which can increase comfort and compliance, and second, the importance of explaining the benefits of the brace and of delaying TKR.
“A good fit can mean the difference between the patient benefiting from the brace or not,” said Jon Divine, MD, medical director for sports medicine at Cincinnati Children’s Hospital Medical Center. “An improperly fitted device is not only uncomfortable, it can exacerbate the symptoms it’s intended to improve.”
Investigators for the Orthopedics study, a group from the Hip Knee Arkansas Foundation in Little Rock, retrospectively reviewed brace use status in 29 individuals using an unloader brace for unicompartmental medial knee OA. All patients initially reported the brace increased function and reduced pain as well as activity-related swelling and stiffness.
Long-term Results of an Unloader Brace in Patients With Unicompartmental Knee Osteoarthritis, Wilson B, Rankin H, Barnes CL. Orthopedics. 2011 Aug 8;34(8):e334-7. doi: 10.3928/01477447-20110627-07.