title: Current state of unloading braces for knee osteoarthritis.
abstract: OBJECTIVE
  Unicompartmental knee osteoarthritis (OA) is often treated with the prescription of an unloading knee brace to decrease pain and stiffness. Braces have been shown to improve the quality of life by applying an external moment to offset increased compressive tibiofemoral contact loads, but evidence regarding mechanical efficacy at the joint is controversial. Thus, the purpose of this study was to review the current state of unloading braces on knee mechanics, clinical impact, and long-term disease progression.
  
  
  METHODS
  A literature search was performed through the PubMed MEDLINE database for the search terms "osteoarthritis," "knee," "brace," and derivatives of the keyword "unload." Articles published since January 1, 1980 were reviewed for their relevance. Evidence for the effectiveness of unloading braces for disease management both biomechanically and clinically was considered.
  
  
  RESULTS
  While significant research has been done to show improvement in OA symptoms with the use of an unloading brace, current literature suggests a debate regarding the effectiveness of these braces for biomechanical change. Clinical findings reveal overall improvements in parameters such as pain, instability, and quality of life.
  
  
  CONCLUSIONS
  Although clinical evidence supports brace use to improve pain and functional ability, current biomechanical evidence suggests that unloading of the affected knee compartment does not significantly hinder disease progression.
  
  
  METHODS
  III.
authors.affiliation: Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
authors.forename: J Richard
authors.initials: JR
authors.lastname: Steadman
authors.affiliation: Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, CO, 81657, USA. karen.briggs@sprivail.org.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Briggs
authors.affiliation: Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Pomeroy
authors.affiliation: Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
authors.forename: Coen A
authors.initials: CA
authors.lastname: Wijdicks
mesh_terms: D001696:Biomechanical Phenomena; D001915:Braces; D006801:Humans; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*
keywords: Brace; Knee; Osteoarthritis; Unload