title: Biomechanical effectiveness of a distraction-rotation knee brace in medial knee osteoarthritis: preliminary results.
abstract: BACKGROUND
  Non-pharmacological therapies are recommended for the care of knee osteoarthritis patients. Unloader knee braces provide an interesting functional approach, which aims to modulate mechanical stress on the symptomatic joint compartment. We aimed to confirm the biomechanical effects and evaluate functional benefits of a new knee brace that combines a valgus effect with knee and tibial external rotation during gait in medial osteoarthritis patients.
  
  
  METHODS
  Twenty patients with unilateral symptomatic medial knee osteoarthritis were included and they performed two test sessions of 3D gait analysis with and without the brace at the initial evaluation (W0) and after 5weeks (W5) of wearing the brace. VAS-pain, satisfaction scores, WOMAC scores, spatio-temporal gait parameters (gait speed, stride length, stance and double stance phases, step width), and biomechanical data of the ipsilateral lower limb (hip, knee, ankle and foot progression angles) were recorded at each session.
  
  
  RESULTS
  VAS-pain and WOMAC significantly decreased at W5. Walking speed was not significantly modified by knee bracing at W0, but increased significantly at W5. Knee adduction moments and foot progression angles significantly decreased in the terminal stance and push off, respectively, with bracing at W0 and W5. Lower-limb joint angles, moments and powers were significantly modified by wearing the brace at W0 and W5.
  
  
  CONCLUSIONS
  This new knee brace with distraction-rotation effects significantly alters knee adduction moments and foot progression angles during gait, which might lead to significant functional gait improvements and have carry-over effects on pain at the short term in osteoarthritis patients (<2 months).
  
  
  METHODS
  level IV.
authors.affiliation: CIC INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France; INSERM U1093, Dijon F-21079, France. Electronic address: davy.laroche@chu-dijon.fr.
authors.forename: Davy
authors.initials: D
authors.lastname: Laroche
authors.affiliation: CIC INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France; INSERM U1093, Dijon F-21079, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Morisset
authors.affiliation: Department of Rheumatology, Dijon University Hospital, Dijon F-21078, France.
authors.forename: Clementine
authors.initials: C
authors.lastname: Fortunet
authors.affiliation: CIC INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon F-21078, France; INSERM U1093, Dijon F-21079, France; Department of Physical Medicine, Dijon University Hospital, Dijon F-21078, France; University of Burgundy, Dijon F-21079, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gremeaux
authors.affiliation: INSERM U1093, Dijon F-21079, France; Department of Rheumatology, Dijon University Hospital, Dijon F-21078, France; University of Burgundy, Dijon F-21079, France.
authors.forename: Jean-Francis
authors.initials: JF
authors.lastname: Maillefert
authors.affiliation: INSERM U1093, Dijon F-21079, France; Department of Rheumatology, Dijon University Hospital, Dijon F-21078, France; University of Burgundy, Dijon F-21079, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Ornetti
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D001915:Braces; D004867:Equipment Design; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies; D064232:Visual Analog Scale
keywords: Biomechanics; Knee brace; Knee osteoarthritis; Locomotion