title: Comparison of three knee braces in the treatment of medial knee osteoarthritis.
abstract: BACKGROUND
  Conservative orthotic treatments rely on different mechanisms, such as three-point bending systems or hinges forcing external rotation of the leg and knee stabilization, to alter the biomechanics of the lower limbs and thus reduce knee loading on the affected compartment in patients with knee osteoarthritis (KOA). No previous study had compared the effects of these mechanisms on external loading and leg kinematics in patients with KOA.
  
  
  METHODS
  Twenty-four patients with medial KOA (Kellgren-Lawrence grade II or III) wore three custom knee braces: a valgus brace with a three-point bending system (V3P-brace), an unloader brace with valgus and external rotation functions (VER-brace) and a functional knee brace used in ligament injuries (ACL-brace). Pain relief, comfort, lower extremity kinematics and kinetics during walking were compared with and without each knee brace.
  
  
  RESULTS
  Knee pain was alleviated with all three braces (p<0.01). The VER- and ACL-braces allowed a significant reduction in peak knee adduction moment (KAM) during terminal stance from 0.313 to 0.280 Nm/Bw∗Ht (p<0.001) and 0.293 to 0.268 (p<0.05), respectively, while no significant reduction was observed with the V3P-brace (p=0.52). Reduced knee adduction and lower ankle and knee external rotation were observed with the V3P-brace but not with the VER-brace. The ACL-brace did not modify lower limb kinematics.
  
  
  CONCLUSIONS
  No difference between the knee braces was found for pain reduction, discomfort or KAM. The VER-brace was slightly more comfortable, which could ensure better compliance with treatment over the long term.
authors.affiliation: Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de recherche FRSQ du CHA universitaire de Québec, Québec, QC, Canada.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Dessery
authors.affiliation: Division de Chirurgie Orthopédique, CHUQ, Québec, QC, Canada; Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada.
authors.forename: Etienne L
authors.initials: EL
authors.lastname: Belzile
authors.affiliation: Division de Chirurgie Orthopédique, CHUQ, Québec, QC, Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Turmel
authors.affiliation: Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC, Canada; Centre de recherche FRSQ du CHA universitaire de Québec, Québec, QC, Canada. Electronic address: philippe.corbeil@kin.ulaval.ca.
authors.forename: Philippe
authors.initials: P
authors.lastname: Corbeil
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control*; D001696:Biomechanical Phenomena / Q000502:physiology; D001915:Braces; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology
keywords: External rotation; Knee adduction moment; Knee brace; Pain; Valgus