Effectiveness of knee bracing in osteoarthritis: pragmatic trial in a multidisciplinary clinic. 2016

Shirley P Yu, and Matthew Williams, and Jillian P Eyles, and Jian Sheng Chen, and Joanna Makovey, and David J Hunter
Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW, Australia.

OBJECTIVE Assessing the effectiveness of bracing treatment for tibiofemoral osteoarthritis (OA) and patellofemoral OA in patients with knee OA. METHODS This study was conducted within the Osteoarthritis Chronic Care Program (OACCP), a 52-week multidisciplinary non-operative program for OA patients. All participants had symptomatic, radiographic knee OA. Knee bracing with Ossur Unloader One and Tru-pull Lite was offered for participants with medial/lateral tibiofemoral and patellofemoral OA, respectively. Participants were assessed at weeks 0, 12, 26 and 52. The primary outcome was knee pain and function at week 52, as assessed by the Knee injury and Osteoarthritis Outcome Score (KOOS) pain and activities of daily living (ADL) scores. Linear regression models were used to compare effectiveness for pain and function between three groups (patellofemoral bracing, tibiofemoral bracing and no bracing). RESULTS There were 204 participants; 50 assigned patellofemoral bracing, 86 tibiofemoral bracing and 68 with no bracing. Mean baseline KOOS pain score was 52.9, 41.7 and 43.3 (0-100 scale where 100 represents normal) and mean baseline KOOS ADL score was 55.8, 43.7 and 43.1 for the three groups, respectively. Significant improvements were found in each group at week 52 for KOOS pain score and KOOS ADL. There was no significant difference in KOOS pain (P = 0.12) and ADL score (P = 0.13) at week 52 between the three brace types after adjusting for baseline variables. CONCLUSIONS A multidisciplinary non-operative program improved pain and function in persons with patellofemoral and tibiofemoral OA. However, wearing a patellofemoral or a tibiofemoral brace did not appear to provide additional benefits.

UI MeSH Term Description Entries
D007719 Knee Joint A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA. Superior Tibiofibular Joint,Joint, Knee,Joint, Superior Tibiofibular,Knee Joints,Superior Tibiofibular Joints,Tibiofibular Joint, Superior
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009517 New South Wales A state in southeastern Australia. Its capital is Sydney. It was discovered by Captain Cook in 1770 and first settled at Botany Bay by marines and convicts in 1788. It was named by Captain Cook who thought its coastline resembled that of South Wales. (From Webster's New Geographical Dictionary, 1988, p840 & Room, Brewer's Dictionary of Names, 1992, p377)
D010147 Pain Measurement Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies. Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D010348 Patient Care Team Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. Health Care Team,Interdisciplinary Health Team,Medical Care Team,Multidisciplinary Care Team,Multidisciplinary Health Team,Healthcare Team,Care Team, Health,Care Team, Medical,Care Team, Multidisciplinary,Care Team, Patient,Care Teams, Health,Care Teams, Patient,Health Care Teams,Health Team, Interdisciplinary,Health Team, Multidisciplinary,Healthcare Teams,Interdisciplinary Health Teams,Medical Care Teams,Multidisciplinary Care Teams,Multidisciplinary Health Teams,Patient Care Teams,Team, Health Care,Team, Healthcare,Team, Interdisciplinary Health,Team, Medical Care,Team, Multidisciplinary Care,Team, Multidisciplinary Health,Team, Patient Care,Teams, Interdisciplinary Health
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D001915 Braces Orthopedic appliances used to support, align, or hold parts of the body in correct position. (Dorland, 28th ed) Brace
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D005260 Female Females

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