Sattari S, Ashraf A R
Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran Red Crescent Med J. 2011 Sep;13(9):624-8. doi: 10.5812/kowsar.20741804.2252. Epub 2011 Sep 15.
There are many opinions and controversies regard the effect of lateral wedge insoles and valgus stress 3point knee braces in treatment of medial compartment knee osteoarthritis (OA). In this study we compared the effect of lateral wedge insoles and 3 point knee supports in treatment of medial compartment knee OA.
Sixty patients (35-65 years), with knee pain and genu varum and moderate to severe medial compartment DJD were divided into three groups. The first group received a custom molded 3 point valgus stress knee support. Lateral wedge insoles were applied for the second group and the third group served as control. All groups were followed for 9 months according to pain severity, walking distance, and radiologic changes.
Pain reduced significantly in both lateral wedge and knee brace groups compared to control group with more significant reduction in the brace group. The walking distance was significantly longer only in the brace group. There was more pronounced effect of brace in patients with severe DJD in walking distance compared to moderate DJD, but not in severity of pain.
Three point valgus stress knee support had more significant effect on pain reduction, walking distance and also radiologic improvement of patients with moderate to severe medial compartment DJD compared to lateral wedge insoles and could even reverse radiologic findings.
关于外侧楔形鞋垫和外翻应力三点式膝关节支具在治疗内侧间室膝关节骨关节炎（OA）中的作用，存在许多观点和争议。在本研究中，我们比较了外侧楔形鞋垫和三点式膝关节支具在治疗内侧间室膝关节OA中的效果。
60例年龄在35至65岁之间、有膝关节疼痛和膝内翻且内侧间室存在中度至重度退行性关节病（DJD）的患者被分为三组。第一组使用定制的三点式外翻应力膝关节支具。第二组使用外侧楔形鞋垫，第三组作为对照组。根据疼痛严重程度、步行距离和影像学变化对所有组进行9个月的随访。
与对照组相比，外侧楔形鞋垫组和膝关节支具组的疼痛均显著减轻，支具组的减轻更为明显。仅支具组的步行距离显著更长。与中度DJD患者相比，重度DJD患者使用支具在步行距离方面的效果更显著，但在疼痛严重程度方面并非如此。
与外侧楔形鞋垫相比，三点式外翻应力膝关节支具对中度至重度内侧间室DJD患者的疼痛减轻、步行距离改善以及影像学改善具有更显著的效果，甚至可以逆转影像学表现。
