Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York.
Sports Health. 2009 Sep;1(5):416-26. doi: 10.1177/1941738109343157.
For persons with unicompartment knee osteoarthritis (OA), off-unloader braces are a mechanical intervention designed to reduce pain, improve physical function, and possibly slow disease progression. Pain relief is thought to be mediated by distracting the involved compartment via external varus or valgus forces applied to the knee. In so doing, tibiofemoral alignment is improved, and load is shifted off the degenerative compartment, where exposure to potentially damaging and provocative mechanical stresses are reduced.
To provide a synopsis of the evidence documented in the scientific literature concerning the efficacy of off-loader knee braces for improving symptomatology associated with painful disabling medial compartment knee OA.
Relevant peer-reviewed publications were retrieved from a MEDLINE search using the terms with the reference terms osteoarthritis, knee, and braces (per Medical Subject Headings), plus a manual search of bibliographies from original and review articles and appropriate Internet resources.
For persons with combined unicompartment knee OA and mild to moderate instability, the strength of recommendation reported by the Osteoarthritis Research Society International in the ability of off-loader knee braces to reduce pain, improve stability, and diminish the risk of falling was 76% (95% confidence interval, 69%-83%). The more evidence the treatment is effective, the higher the percentage.
Given the encouraging evidence that off-loader braces are effective in mediating pain relief in conjunction with knee OA and malalignment, bracing should be fully used before joint realignment or replacement surgery is considered. With the number of patients with varus deformities and knee pain predicted to increase as the population ages, a reduction of patient morbidity for this widespread chronic condition in combination with this treatment modality could have a positive impact on health care costs and the economic productivity and quality of life of the affected individuals.
对于单侧膝关节骨关节炎（OA）患者，减负支具是一种机械干预措施，旨在减轻疼痛、改善身体功能，并可能减缓疾病进展。人们认为，通过向膝关节施加外部内翻或外翻力来分散受累关节，可以实现缓解疼痛的效果。这样做可以改善胫股对线，并将负荷从退行性关节间隙转移开，从而减少潜在的破坏性和刺激性机械应力的暴露。
提供科学文献中关于减负支具改善与疼痛性、致残性内侧间室膝关节 OA 相关症状的疗效证据概述。
使用医学主题词（MeSH）中的“骨关节炎、膝关节和支具”等术语，从 MEDLINE 搜索中检索相关同行评审出版物，并对原始和综述文章的参考文献和适当的互联网资源进行手动搜索。
对于同时患有单侧膝关节 OA 和轻度至中度不稳定的患者，国际骨关节炎研究协会（Osteoarthritis Research Society International）报告的减负支具减轻疼痛、改善稳定性和降低跌倒风险的能力的推荐强度为 76%（95%置信区间，69%-83%）。治疗效果的证据越有力，百分比就越高。
鉴于减负支具在缓解膝关节 OA 和对线不良相关疼痛方面的疗效令人鼓舞，在考虑进行关节矫正或置换手术之前，应充分使用支具。随着人口老龄化，预计患有内翻畸形和膝关节疼痛的患者数量将会增加，如果这种治疗方式能够结合这种治疗方式，可以减少这种广泛的慢性疾病对患者的发病率，这可能会对医疗成本以及受影响个体的经济生产力和生活质量产生积极影响。
