Ornetti P, Fortunet C, Morisset C, Gremeaux V, Maillefert J F, Casillas J M, Laroche D
Service de rhumatologie, CHU Bocage, 21078 Dijon, France; Inserm U1093, université de Bourgogne, 21079 Dijon, France.
Service de rhumatologie, centre hospitalier William-Morey, 71321 Chalon-sur-Saône, France.
Ann Phys Rehabil Med. 2015 Jun;58(3):126-31. doi: 10.1016/j.rehab.2015.03.004. Epub 2015 May 23.
Evaluation of the clinical effectiveness and safety of a new custom-made valgus knee brace (OdrA) in medial knee osteoarthritis (OA) in terms of pain and secondary symptoms.
Open-label prospective study of patients with symptomatic medial knee OA with clinical evaluation at 6 and 52 weeks (W6, W52). We systematically assessed pain on a visual analog scale (VAS), Knee injury and Osteoarthritis Outcome Score (KOOS), spatio-temporal gait variables, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesic-sparing effects of the brace and tolerance. Mean scores were compared at baseline, W6 and W52 and the effect size (ES) and 95% confidence intervals (95% CIs) were calculated.
We included 20 patients with knee OA (mean age 64.2±10.2 years, mean body mass index 27.2±5.4 kg/m2). VAS pain and KOOS were improved at W6 and W52: pain (ES=0.9 at 1 year), amelioration of other symptoms (ES=0.4), and function in activities of daily living (ES=1.1), sports and leisure (ES=1.5), quality of life (ES=0.9) and gait speed (ES=0.41). In total, 76% of patients showed clinical improvement at 1 year. Analgesic and NSAIDs consumption was significantly decreased at W6 and W52. One serious adverse effect noted was lower-limb varices, and observance was deemed satisfactory at 1 year.
This new unloader brace appeared to have good effect on medial knee OA, with an acceptable safety profile and good patient compliance.
评估一种新型定制外翻膝关节支具(OdrA)在内侧膝关节骨关节炎(OA)中对疼痛和继发症状的临床有效性及安全性。
对有症状的内侧膝关节OA患者进行开放标签前瞻性研究,在6周和52周(W6、W52)进行临床评估。我们系统地通过视觉模拟量表(VAS)评估疼痛、膝关节损伤和骨关节炎结局评分(KOOS)、时空步态变量、非甾体抗炎药(NSAIDs)的使用情况以及支具的镇痛效果和耐受性。比较基线、W6和W52时的平均得分,并计算效应大小(ES)和95%置信区间(95%CI)。
我们纳入了20例膝关节OA患者(平均年龄64.2±10.2岁,平均体重指数27.2±5.4kg/m²)。VAS疼痛和KOOS在W6和W52时得到改善:疼痛(1年时ES = 0.9)、其他症状改善(ES = 0.4)、日常生活活动功能(ES = 1.1)、运动和休闲功能(ES = 1.5)、生活质量(ES = 0.9)和步速(ES = 0.41)。总体而言,76%的患者在1年时显示出临床改善。W6和W52时镇痛药和NSAIDs的消耗量显著降低。记录到的1例严重不良反应是下肢静脉曲张,1年时观察情况被认为令人满意。
这种新型卸载支具似乎对内侧膝关节OA有良好效果,安全性可接受,患者依从性良好。