Knee braces and foot orthoses multimodal treatment of medial knee osteoarthritis.

BACKGROUND

Knee braces and lateral wedge foot orthoses are two treatment options recommended for medial knee osteoarthritis, but the combination of both of them could further improve their effectiveness.

RESEARCH QUESTION

The aim was to evaluate whether the combination of lateral wedge foot orthoses with two types of knee brace enhances the biomechanical effects and pain relief during the stance phase of gait while maintaining comfort.

METHODS

Ten patients with medial knee osteoarthritis were fitted with a standard valgus brace, an unloader brace with valgus and external rotation functions, and 7° lateral wedge foot orthoses. The pain relief, comfort, kinematics and kinetics of the lower limb were measured during walking without orthotics, with the combined and with the isolated treatments.

RESULTS

The valgus and external rotation brace significantly reduced the knee adduction moment and allowed more knee flexion both in isolation and in combination to foot orthoses compared to the valgus brace or without treatment. Pain relief was not significant with the different orthotic treatment modalities. The valgus brace and combined treatment with either brace significantly increased the discomfort level, whereas the valgus and external rotation brace or foot orthoses in isolation did not induce significant discomfort.

SIGNIFICANCE

Amongst the tested orthotic treatment modalities, the valgus and external rotation brace obtained better biomechanical outcomes while maintaining comfort. The combined treatment with foot orthoses enhanced the effectiveness of the valgus brace, however foot orthoses may be unnecessary with the valgus and external rotation brace.