Schwarze M, Bartsch L P, Block J, Wolf S I, Alimusaj M
Klinik für Orthopädie und Unfallchirurgie, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland.
Orthopade. 2020 May;49(5):449-459. doi: 10.1007/s00132-019-03802-w.
Osteoarthritis is the most common joint disease worldwide and mostly affects the knee joint (gonarthrosis). In treatment algorithms, technical aids in the form of laterally wedged insoles, valgizing knee braces and ankle-foot orthoses have an importance in the treatment of medial unicompartmental knee joint disease. However, national and international guidelines differ in their recommendations.
Taking into account a great amount of scientific work, the measurable effect of laterally wedged insoles appears to be low, so that a justifying indication only exists at low gonarthrosis levels.
Valgizing knee braces have shown stronger biomechanical and clinical effects, but with a slightly increased complication potential and low compliance. Low to medium-grade arthrosis can be treated.
ANKLE-FOOT ORTHOSES: Ankle-foot arthroses have not yet been conclusively examined. Initial work indicates biomechanical and clinical efficacy. The overall effects and indications appear comparable to knee braces, probably with less complication potential.
骨关节炎是全球最常见的关节疾病，主要影响膝关节（膝关节炎）。在治疗方案中，外侧楔形鞋垫、膝关节外翻矫正支具和踝足矫形器等技术辅助器具在治疗内侧单髁膝关节疾病中具有重要作用。然而，国内和国际指南的推荐意见存在差异。
考虑到大量的科学研究工作，外侧楔形鞋垫的可测量效果似乎较低，因此仅在膝关节炎程度较轻时才存在合理的适应证。
膝关节外翻矫正支具已显示出更强的生物力学和临床效果，但并发症风险略有增加且依从性较低。可用于治疗轻至中度关节炎。
踝足关节炎尚未得到最终研究。初步研究表明其具有生物力学和临床疗效。总体效果和适应证似乎与膝关节矫正支具相当，可能并发症风险较小。
