title: Biomechanical effect of unloader braces for medial osteoarthritis of the knee: a systematic review (CRD 42015026136).
abstract: OBJECTIVE
  There is a lack of consensus regarding biomechanical effects of unloader braces for the treatment of medial osteoarthritis (OA) of the knee. The purpose of this study was to perform a systematic review of studies examining the biomechanical effect of unloader braces.
  
  
  METHODS
  A systematic search for articles about the biomechanical effect of unloader braces was performed. Primary outcome measure was the influence of the brace on the knee adduction moment. Data sources were Pubmed central and google scholar.
  
  
  RESULTS
  Twenty-four articles were included. Twenty articles showed that valgus unloader braces significantly decrease the knee adduction moment. Seven of those studies reported a decrease of pain in braced patients (secondary outcome measure). Positive effects on the knee adduction moment could be found for custom made braces for conventional knee braces and for a foot ankle orthosis. Four studies could not show any effect of knee unloader braces on the knee adduction moment although one of these studies found decreased pain in braced patients. One of these studies examined healthy patients with a neutral axis.
  
  
  CONCLUSIONS
  This systematic review could demonstrate evidence that unloader braces reduce the adduction moment of the knee. Foresighted, a systematic review about the clinical effect of unloader braces is required.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Caspar Theysstr 27-31, 14193, Berlin, Germany. wolf.petersen@pgdiakonie.de.
authors.forename: Wolf
authors.initials: W
authors.lastname: Petersen
authors.affiliation: Arcus Sportklinik, Pforzheim, Germany.
authors.forename: Andree
authors.initials: A
authors.lastname: Ellermann
authors.affiliation: Sporthopaedicum, Straubing, Germany.
authors.forename: Thore
authors.initials: T
authors.lastname: Zantop
authors.affiliation: Deutsche Sporthochschule, Cologne, Germany.
authors.forename: Ingo Volker
authors.initials: IV
authors.lastname: Rembitzki
authors.affiliation: Ortema, Markgröningen, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Semsch
authors.affiliation: Asklepios Klinikum Bad Harzburg, Bad Harzburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Liebau
authors.affiliation: Sportklinik Stuttgart, Stuttgart, Germany.
authors.forename: Raymond
authors.initials: R
authors.lastname: Best
mesh_terms: D001915:Braces; D005684:Gait / Q000502:physiology*; D006801:Humans; D007717:Knee / Q000502:physiology / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000534:rehabilitation*; D010146:Pain / Q000517:prevention & control
keywords: Biomechanics; Knee adduction moment; Medial osteoarthritis; Varus malalignement