Authors (including presenting author) :
Ng KY(1), Wan KHM(1), Choi ST(1), Wong KK(1), LH Tai(2), Fung KYB (3)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong SAR
(2) Department of Occupational Therapy Kwong Wah Hospital, Hong Kong SAR
(3) Department of Physiotherapy, Kwong Wah Hospital, Hong Kong SAR
Introduction :
Osteoarthritis of the knee is the most common type of arthritis affecting the middle age and geriatric population, which poses a huge burden to our in-patient and out-patient clinical service.
Orthotic device can theoretically alter the loading to the knee joint and help to provide symptomatic relief. Small scale biomechanical studies have demonstrated such effects. Though prospective clinical studies on our Chinese patients are lacking.
Objectives :
The purpose of the study is to evaluate the effectiveness of valgus knee brace in ethnic Chinese patients with medial compartment knee osteoarthritis compared with physiotherapy.
Methodology :
A prospective randomized controlled study from January 2020 to December 2021 was carried out in our institution. Patients with medial knee osteoarthritis were recruited. Patient with radiological evidence of symptomatic medial compartment osteoarthritis were recruited from our out-patient clinic. Patients with significant knee effusion, soft tissue compromise preventing the use of knee brace, obese patients (BMI > 30), and with previous surgery on the affected knee were excluded. They were randomized into 2 groups. Patients in the control group received a course of standardized, protocol driven knee physiotherapy. Patients in the knee brace group the same course of physiotherapy, with the additional prescription of valgus knee brace. They were advised to wear the knee brace for a minimum of 4 hours per day.
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analogue scale scores (VAS) were used as outcome measured.
Patients were assessed before the treatment, and at 16 weeks after the treatment. The assessors were blinded from the patients’ grouping allocation.
Result & Outcome :
50 patients were recruited. 29 and 21 patients were recruited into the control and knee brace group respectively, with 4 and 3 of them dropped out during the follow up from each of the groups respectively. There were totally 43 valid results (25 from control group and 18 from knee brace group) for statistics evaluation.
Compared with pretreatment, both groups of patients showed improvement in WOMAC score (pain, functional and total) as well as VAS (p < 0.01). When comparing the control and knee brace group, WOMAC (functional) score of the knee brace group had significantly improved compared to the control group (p < 0.05). For WOMAC (pain, stiffness and total) score and VAS, the knee brace group did not showed a significant improvement compared to the control group.
In conclusion, both physiotherapy and valgus knee braces were effective in providing symptomatic relief in patients with medial compartment osteoarthritis.
