Knee braces and foot orthoses multimodal 3-month treatment of medial knee osteoarthritis in a randomised crossover trial

Auteurs

Xavier Robert-Lachaine, Département de Kinésiologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada, Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC, Canada, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC, Canada
Yoann Dessery, Département de Kinésiologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
Étienne L. Belzile, Division de Chirurgie Orthopédique, CHU de Québec Université Laval, Quebec City, QC, Canada, Département de Chirurgie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
Philippe Corbeil, Département de Kinésiologie, Faculté de Médecine, Université Laval, Quebec City, QC, Canada, Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC, Canada

Type de document

Études primaires

Année de publication

2024

Langue

Anglais

Titre de la revue

Knee Surgery, Sports Traumatology, Arthroscopy

Résumé

Purpose: Immediate biomechanical and functional benefits of knee braces and lateral wedge foot orthoses (FO) are often reported on patients with medial knee osteoarthritis. However, the effectiveness of their combined use in a longer-term orthotic treatment remains unclear. The aim was to evaluate pain, function, comfort and knee adduction moment (KAM) during the stance phase of gait with three modalities of orthotic treatment. Methods: Twenty-two patients with knee osteoarthritis were analysed in a randomised crossover trial including a knee brace with valgus and external rotation functions (VER), FO and their combined use (VER + FO). Western Ontario and McMaster Universities scale (WOMAC) and Knee injury and Osteoarthritis Outcome Scores and KAM during gait were obtained before and after each orthotic treatment of 3 months. Repeated measures analyses of variance contrasted the factors orthosis (VER, FO, VER + FO), treatment (pre and post) and wear (without and with) on pain, function, comfort and KAM. Results: An interaction between orthosis and treatment on the WOMAC pain (effect size [ES] = 0.17) and a main effect on the pain visual analogue score (ES = 0.24) indicated that VER and VER + FO were more alleviating than FO. The three modalities of orthotic treatment significantly improved functional scores (ES > 0.2) and reduced discomfort (ES = 0.25). A significant multivariate interaction between orthosis and wear (ES = 0.73) showed that the KAM reduction while wearing the orthoses was more pronounced with the VER and VER + FO than the FO. Conclusion: The VER-brace obtained more effectiveness than FO on pain and KAM after 3 months for medial knee osteoarthritis and the combined treatment did not substantially improve biomechanical and functional outcomes. Level of Evidence: Therapeutic study level I randomised crossover trial. © 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.

Mots-clés

Genou, Knee, Orthèse, Orthesis, Troubles musculosquelettiques, Musculoskeletal disease, Traitement médical, Medical treatment, Réadaptation physique, Physical rehabilitation

Numéro de projet IRSST

n/a

Citation recommandée

Robert-Lachaine, X., Dessery, Y., Belzile, É. L. et Corbeil, P. (2024). Knee braces and foot orthoses multimodal 3-month treatment of medial knee osteoarthritis in a randomised crossover trial. Knee Surgery, Sports Traumatology, Arthroscopy. https://doi.org/10.1002/ksa.12312