Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Epistemonikos, Santiago, Chile.
Proyecto Epistemonikos, Santiago, Chile; Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Medwave. 2021 Apr 28;21(3):e8115. doi: 10.5867/medwave.2021.03.8114.
Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication.
We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.
膝骨关节炎的发病率高且致残率高,是一个重要的健康问题。在非药物治疗方法中,已经提出使用减荷膝矫形器,但是在其适应证方面,文献中尚无共识。
我们在 Epistemonikos 中进行了检索,这是一个最大的健康系统评价数据库,通过筛选多个信息来源(包括 MEDLINE、EMBASE、Cochrane 等)进行维护。我们从系统评价中提取数据,重新分析原始研究的数据,进行荟萃分析,并使用 GRADE 方法生成证据总结表。
我们共纳入了 14 篇系统评价,其中包括 9 项研究,均为随机试验。我们的结论是,膝骨关节炎患者使用减荷膝矫形器可能会通过增加步行距离来提高身体功能。然而,其使用在膝关节外科医院评分(Hospital for Special Surgery Knee score)测量的身体功能方面可能没有差异或差异较小,它可能会略微降低生活质量并增加不良事件,但证据的确定性较低。此外,我们不确定使用减荷膝矫形器是否能减轻疼痛,因为证据的确定性被评估为非常低。