Role of bracing in the management of knee osteoarthritis.
OBJECTIVE
Recommendations for nonpharmacological treatment for knee osteoarthritis are based mainly on modifying the symptomatic loading joint compartment. Braces are one of the modalities used to modify joint loading. Knee osteoarthritis braces consist of rest orthoses, knee sleeves, and unloading-knee braces. This review examines the most recent publications regarding the various bracing modalities proposed for different knee osteoarthritis compartments.


RESULTS
The effectiveness of rest orthoses for lower-limb osteoarthritis has not been studied in clinical trials. Knee sleeves are elastic nonadhesive orthoses associated with various devices aimed at patellar or femoro-tibial stabilization. They may decrease knee pain. Unloading-knee braces are functional devices composed of external stems, hinges, and straps. Several recent biomechanical studies have established the effectiveness of modifying loading with unloading-knee braces. Such braces may decrease knee pain, and improve knee function.


CONCLUSIONS
Braces are recommended for treating knee osteoarthritis. The different bracing modalities that are available must be adapted to the symptomatic knee osteoarthritis compartment. This nonpharmacological approach must be added to the other nonpharmacological, and pharmacological modalities to decrease pain and improve function and thereby increase the quality of life of osteoarthritis patients. The structural effect of bracing has not yet been evaluated. High-quality clinical trials of the addition of various treatment modalities for knee osteoarthritis are still necessary.
Rannou
François
F
INSERM, U747, Laboratoire de Pharmacologie, Toxicologie et Signalisation Moléculaire, Paris, France. francois.rannou@cch.aphp.fr
Poiraudeau
Serge
S
Beaudreuil
Johan
J
D001696:Biomechanical Phenomena / Q000502:physiology; D001915:Braces; D019317:Evidence-Based Medicine; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016474:Weight-Bearing / Q000502:physiology