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General Orthopaedics

KNEE BRACES 2014: WHAT PURPOSE DO THEY SERVE?

Current Concepts in Joint Replacement (CCJR) – Winter 2014



Abstract

Osteoarthritis (OA) is a highly prevalent disease that has a debilitating role in every day function and activity. In 2002, the indirect cost of OA was 5 billion dollars, secondary to absenteeism and loss of productivity. There are multiple management options available for OA, with surgery usually being a last resort. Total knee arthroplasty (TKA) provides a long-lasting treatment option with excellent results. However, a high proportion of patients still express dissatisfaction following surgery, possibly due to a combination of pain, continued limitation of function, and high expectations. The use of bracing provides a non-operative treatment option as well as a useful therapy adjunct in patients who undergo TKA. Bracing may aid in rehabilitation prior to TKA as well as postoperatively, and it also plays a beneficial role in problematic situations, such as patients who have undergone revision surgery or who have extensor mechanism problems. They are thought to aid in gait ‘retraining’, quadriceps muscle strengthening, improving joint alignment, and increasing stability of the joint. Although the American Academy of Orthopedic Surgeons remains inconclusive on the role of bracing, multiple studies have highlighted that they may be of benefit. The use of valgus bracing has been shown to provide short-term treatment for activity, bracing for uni-compartmental OA has shown an improvement in outcome measures, and the use of an unloader brace has led to improved general physical health and function outcomes, as measured by the SF-12 and WOMAC, respectively.