Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial
Background and purpose: For medial knee osteoarthritis (OA), operative and nonoperative treatment options are available. Two widely applied unloading therapies are a valgus unloader brace and a high tibial osteotomy (HTO). We aimed to compare the effects of a valgus unloader knee brace with an HTO...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-01-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/42846 |
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| author | Mark Stam Joost Verschueren Mark V van Outeren Reinoud W Brouwer Robert D A Gaasbeek Sorin G Blendea Eline M van Es Max Reijman Sita M A Bierma-Zeinstra |
| author_facet | Mark Stam Joost Verschueren Mark V van Outeren Reinoud W Brouwer Robert D A Gaasbeek Sorin G Blendea Eline M van Es Max Reijman Sita M A Bierma-Zeinstra |
| author_sort | Mark Stam |
| collection | DOAJ |
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Background and purpose: For medial knee osteoarthritis (OA), operative and nonoperative treatment options are available. Two widely applied unloading therapies are a valgus unloader brace and a high tibial osteotomy (HTO). We aimed to compare the effects of a valgus unloader knee brace with an HTO on knee pain after 1 year in patients with symptomatic medial knee OA.
Methods: We recruited patients from 9 Dutch hospitals between August 2014 and February 2019 for an open-labeled multi-center randomized controlled trial (Dutch Trial Register NL4200). Patients aged 18 to 65 years with symptomatic medial compartmental knee OA were randomized to either a valgus unloader brace or an HTO. The primary outcome was the pain subscale of the Knee injury and Osteoarthritis Outcome score (KOOS) after 1 year. Patients were evaluated at 3, 6, 9, 12, and 24 months.
Results: 51 patients were included in the study, of whom 23 were randomized to the unloader brace and 28 to the HTO. The HTO, compared with the unloader brace, showed a significant and clinically relevant difference at 12 months of follow-up in KOOS pain of –28 (95% confidence interval –43 to –13).
Conclusion: We found that, on group level, an HTO is more effective in reducing knee pain than an unloader brace after 12 months.
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| format | Article |
| id | doaj-art-400b29ccab7646b5b4914f725090237a |
| institution | Kabale University |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-400b29ccab7646b5b4914f725090237a2025-01-20T18:36:18ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822025-01-019610.2340/17453674.2025.42846Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trialMark Stam0https://orcid.org/0009-0000-8493-9928Joost Verschueren1https://orcid.org/0000-0002-4951-5158Mark V van Outeren2Reinoud W Brouwer3Robert D A Gaasbeek4Sorin G Blendea5Eline M van Es6https://orcid.org/0000-0001-5346-4237Max Reijman7https://orcid.org/0000-0001-6316-9629Sita M A Bierma-Zeinstra8https://orcid.org/0000-0003-1280-5896Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam, the NetherlandsDepartment of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam; 2 Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the NetherlandsDepartment of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam, the NetherlandsDepartment of Orthopaedic Surgery, Martini Hospital, Groningen, the NetherlandsDepartment of Orthopedics and Traumatology, Meander Medical Center, Amersfoort, the NetherlandsDepartment of Orthopaedic Surgery, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, the NetherlandsDepartment of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam, the NetherlandsDepartment of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam, the NetherlandsDepartment of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam; Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, the Netherlands Background and purpose: For medial knee osteoarthritis (OA), operative and nonoperative treatment options are available. Two widely applied unloading therapies are a valgus unloader brace and a high tibial osteotomy (HTO). We aimed to compare the effects of a valgus unloader knee brace with an HTO on knee pain after 1 year in patients with symptomatic medial knee OA. Methods: We recruited patients from 9 Dutch hospitals between August 2014 and February 2019 for an open-labeled multi-center randomized controlled trial (Dutch Trial Register NL4200). Patients aged 18 to 65 years with symptomatic medial compartmental knee OA were randomized to either a valgus unloader brace or an HTO. The primary outcome was the pain subscale of the Knee injury and Osteoarthritis Outcome score (KOOS) after 1 year. Patients were evaluated at 3, 6, 9, 12, and 24 months. Results: 51 patients were included in the study, of whom 23 were randomized to the unloader brace and 28 to the HTO. The HTO, compared with the unloader brace, showed a significant and clinically relevant difference at 12 months of follow-up in KOOS pain of –28 (95% confidence interval –43 to –13). Conclusion: We found that, on group level, an HTO is more effective in reducing knee pain than an unloader brace after 12 months. https://actaorthop.org/actao/article/view/42846BiomechanicsHigh tibial osteotomyOsteoarthritisKneeUnloader brace |
| spellingShingle | Mark Stam Joost Verschueren Mark V van Outeren Reinoud W Brouwer Robert D A Gaasbeek Sorin G Blendea Eline M van Es Max Reijman Sita M A Bierma-Zeinstra Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial Acta Orthopaedica Biomechanics High tibial osteotomy Osteoarthritis Knee Unloader brace |
| title | Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial |
| title_full | Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial |
| title_fullStr | Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial |
| title_full_unstemmed | Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial |
| title_short | Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial |
| title_sort | unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis a randomized controlled trial |
| topic | Biomechanics High tibial osteotomy Osteoarthritis Knee Unloader brace |
| url | https://actaorthop.org/actao/article/view/42846 |
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