Article

The purpose of this review is to determine the effectiveness of knee orthoses in the treatment of pain in unilateral
compartment osteoarthritis (OA). OA is the most common disorder affecting synovial joints, with structural changes of
OA present in approximately half of the adults. The knee is the most commonly affected joint. Many treatments have been
developed for OA, including the unloader knee orthosis.
The principle of the unloader knee orthosis is to create a varus
or valgus moment at the knee²theoretically creating additional space in the joint compartment, thus relieving pain
caused by bone-on-bone contact. Several studies have been done, but none with a power or number of participants were
large enough to demonstrate effective treatment of OA. Using the keywords "knee osteoarthritis" and "orthosis" or "brace,"
the PubMed, CINAHL, RECAL, and ISI Web of Knowledge electronic databases were searched for randomized control trials
with "orthoses" or "braces" for the knee between January 1980 and December 2010. Only studies that dealt with medial
unilateral compartment knee OA and the use of a knee orthosis were selected. Of these articles, only experimental trials
were selected based on the American Academy of Orthotists and Prosthetists State-of-the-Science Evidence Report
Guidelines. A comparative analysis of the articles was used to determine the effectiveness of the orthoses in reducing pain.
Forty-six initial articles were found. Of these, 15 articles were ultimately included and reviewed based on the inclusion
guidelines. Most of these articles were either single-subject research or before-and-after studies. The majority were of
moderate quality. Statistically significant pain reduction was noted by 73% of the studies reviewed, although all showed
that there was pain reduction in the patients. Patient function and orthosis efficacy were also briefly examined, showing
moderate increases of function. The rate of pain relief was further investigated and revealed that pain relief was almost
immediate. OA knee orthoses are a cost-effective way to reduce pain in patients with medial compartment OA.

Langue : ANGLAIS