Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee.

The biomechanical effectiveness of a valgus-inducing knee brace was investigated for 16 patients with knee osteoarthritis (mean +/- standard deviation age 56 +/- 10 yr, height 172 +/- 9 cm, mass 83 +/- 7 kg, body mass index 27.6 +/- 4.5 kg/m(2)). At the time of investigation, all subjects had been wearing the brace for at least 4 weeks. In addition to conducting standard gait analysis, we calculated the valgus moment generated by the brace by using a novel system that measured the actual deformation of the brace during stance phase and determined the reaction force created by the brace on the leg. The mean maximum value of the orthotic valgus moment was 0.053 Nm/kg, which represents approximately 10% of the external genu varus moment without the brace. This finding may explain the pain relief reported by patients using such braces in clinical studies. Use of the tested brace also decreased the magnitude of gait asymmetry between the braced and contralateral legs during walking (horizontal ground reaction force, external knee flexion moment), presumably because the subjects' need to walk abnormally to shield the knee from pain was reduced.

[1]  K. An,et al.  Gait characteristics of patients with knee osteoarthritis. , 2001, Journal of biomechanics.

[2]  D. Dennis,et al.  An in vivo analysis of the effectiveness of the osteoarthritic knee brace during heel-strike of gait. , 1999, The Journal of arthroplasty.

[3]  A. Amendola,et al.  The effect of bracing on varus gonarthrosis. , 1999, The Journal of bone and joint surgery. American volume.

[4]  J C Goh,et al.  Gait analysis study on patients with varus osteoarthrosis of the knee. , 1993, Clinical orthopaedics and related research.

[5]  R. Loomer,et al.  Valgus Knee Bracing for Medical Gonarthrosis , 1993 .

[6]  R. Greenwald,et al.  A biomechanical analysis of a medial unloading brace for osteoarthritis in the knee. , 2000, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[7]  Joint Loading Gait Analysis Knee Biomechanics VALGUS BRACING FOR KNEE OSTEOARTHRITIS: A BIOMECHANICAL AND CLINICAL OUTCOME STUDY , 1999 .

[8]  R. Strachan,et al.  AN ANALYSIS OF GAIT SYMMETRY , 2000 .

[9]  Timothy E. McAlindon,et al.  Osteoarthritis: New Insights , 2002 .

[10]  L. Weidenhielm,et al.  Adduction moment of the knee compared to radiological and clinical parameters in moderate medical osteoarthrosis of the knee. , 1994, Annales chirurgiae et gynaecologiae.

[11]  N. Fukui,et al.  Change of bone mineral density with valgus knee bracing , 1999, International Orthopaedics.

[12]  T. Andriacchi,et al.  Increased knee joint loads during walking are present in subjects with knee osteoarthritis. , 2002, Osteoarthritis and cartilage.

[13]  Sherry I Backus,et al.  Reduction of Medial Compartment Loads with Valgus Bracing of the Osteoarthritic Knee , 2002, The American journal of sports medicine.

[14]  T. Andriacchi,et al.  Interaction between active and passive knee stabilizers during level walking , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  F. Noyes,et al.  Decrease in knee joint pain and increase in function in patients with medial compartment arthrosis: a prospective analysis of valgus bracing. , 1998, Orthopedics.

[16]  Lars Weidenhielm,et al.  Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis , 2003, Acta orthopaedica Scandinavica.

[17]  Wolfgang Potthast,et al.  The effect of valgus bracing on the knee adduction moment during gait and running in male subjects with varus alignment. , 2010, Clinical biomechanics.

[18]  R. Strachan,et al.  Improvement in function after valgus bracing of the knee. An analysis of gait symmetry. , 2000, The Journal of bone and joint surgery. British volume.

[19]  T P Andriacchi,et al.  Joint Loading With Valgus Bracing in Patients With Varus Gonarthrosis , 1997, Clinical orthopaedics and related research.

[20]  Jacques Duysens,et al.  Valgus bracing in patients with medial compartment osteoarthritis of the knee. A gait analysis study of a new brace. , 2007, Gait & posture.

[21]  D. Kerrigan,et al.  Predicting peak kinematic and kinetic parameters from gait speed. , 2003, Gait & posture.

[22]  S. C. White,et al.  Relation of vertical ground reaction forces to walking speed , 1996 .

[23]  L. Paulos,et al.  Clinical and biomechanical evaluation of the unloading brace. , 2002, The journal of knee surgery.

[24]  H. Matsuno,et al.  Generation II knee bracing for severe medial compartment osteoarthritis of the knee. , 1997, Archives of physical medicine and rehabilitation.

[25]  T. Andriacchi,et al.  The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[26]  Aminudin Che Ahmad,et al.  Atlas of standard radiographs of arthritis addendum: the ankle , 2009 .