title: Unloader knee braces for osteoarthritis: do patients actually wear them?
abstract: BACKGROUND
  Unloader braces are a nonsurgical approach for predominantly unicompartmental knee arthritis. Although noninvasive, braces are expensive and it is unclear whether clinical factors, if any, will predict regular brace use.
  
  
  OBJECTIVE
  We asked: (1) Do patients continue to use the unloader brace more than 1 year after it is prescribed? (2) Do any clinical or radiographic factors predict continued use of the unloader brace after the first year? (3) What are the most common subjective reasons that patients give for discontinuing the brace?
  
  
  METHODS
  We administered 110 surveys to all patients who were fitted for unloader knee braces for predominantly unicompartmental osteoarthritis 12 to 40 months before administration of the survey. Standardized indications and fitting protocols were used. The following parameters were tested for association with ongoing brace use: alignment, arthritis severity, compartment involved, BMI, weight, age, gender, pain and function, number of refittings, and problems with the brace. The survey response rate was 81% (89 of 110).
  
  
  RESULTS
  Of the 89 responders, 28% reported regular brace use (twice per week, an hour at a time, or more); at 2 years, 25% used the brace regularly. No clinical or radiographic factors considered were associated with ongoing brace use. Patients reported lack of symptomatic relief, brace discomfort, poor fit, and skin irritation as reasons for discontinuing the brace.
  
  
  CONCLUSIONS
  Surgeons and patients need to balance the benefits and absence of complications of bracing against cost and the low likelihood of ongoing use 1 year or more after the prescription of the brace.
authors: Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356500, Seattle, WA 98195, USA.
authors: Emily
authors: E
authors: Squyer
authors: Daniel L
authors: DL
authors: Stamper
authors: Deven T
authors: DT
authors: Hamilton
authors: Janice A
authors: JA
authors: Sabin
authors: Seth S
authors: SS
authors: Leopold
mesh_terms: D001915:Braces; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010146:Pain / Q000473:pathology / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D010349:Patient Compliance; D016312:Treatment Refusal
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