Inexpensive Knee Brace Helps Reduce Pain and Joint Damage in Patients with Osteoarthritis

VBCR - February 2014, Volume 3, No 1 - Osteoarthritis
Alice Goodman

By Alice Goodman

San Diego, CA—A low-tech, inexpensive, slip-on knee brace reduces pain and joint damage associated with osteoarthritis (OA), according to a study presented at the 2013 American College of Rheumatology meeting. This is the first study to quantify the effect of a knee brace on pain and joint damage in patients with OA, according to the authors.

The effect on joint damage was assessed using change in volume of bone marrow lesions. The volume of the bone marrow lesions can serve as a marker for effectiveness of treatments, noted lead author David Felson, MD, Boston University, MA.

Bone marrow lesions are thought to represent areas of bone trauma caused by increased focal stress across the knee. Bone marrow lesions fluctuate in volume in as little time as 6 weeks, he added.

“There is a pressing need for nonsurgical interventions for knee OA, but there are no currently approved structure-modifying treatments. Bone marrow lesion change offers a tremendous opportunity for drug development in osteoarthritis. Unlike cartilage loss, a bone marrow lesion is associated with pain. Bone marrow lesions could be a structural treatment target if we can demonstrate repeatedly that treatments affect bone marrow lesion,” Dr Felson stated.

The authors sought to assess change in bone marrow lesions as a treatment target and the effect of the knee brace on OA-related pain using the BioSkin patellar tracking Q brace (Össur Inc, Foothill Ranch, CA).

Overall, 126 patients with painful knee OA were randomized to wear the brace or no brace. The brace was worn for a median of 7.35 hours daily for 6 weeks. Patients did not participate in any exercise program over the course of the study.

All of the patients included in the study had x-ray evidence of knee joint damage and tender knee joints on physical examination. The mean age was approximately 55 years, slightly more than 50% of the patients were women, and the median body mass index was >30 kg/m2. At baseline, all patients reported knee pain during daily activities that put stress on the knee, including climbing stairs, kneeling, and prolonged sitting or squatting.

Impressive Results
The primary outcome measure was change in visual analog scale (VAS) pain score (range, 0-100: 0 = least pain, 100 = most severe pain) during physical activity. Patients in the brace group had a substantial reduction in VAS of approximately 18 points during physical activity, while those in the no-brace group had almost no change in VAS during activity (P <.001). The knee OA outcome score pain subscale showed substantial pain reduction in the treatment group, but not in the control group.

At baseline, bone marrow lesion volumes in the patellofemoral joint, which is the joint targeted by the brace, were almost identical in the 2 groups on contrast magnetic resonance imaging. At 6 weeks, contrast magnetic resonance imaging revealed a significant 25% decrease in bone marrow lesion volume of the patellofemoral joint in patients randomized to the brace versus no brace (P = .02). No difference in bone marrow lesion volume change was observed from baseline to 6 weeks in the control group.

The study was 6 weeks long, and Dr Felson acknowledged that OA is a chronic condition that would require long-term use of the brace. After an additional 3 months, 75% of the patients were still wearing the brace. “The brace appears to be feasible as a longer-term strategy,” he noted.

Related Items
Working in Cold Environment Increases Risk for RA
Alice Goodman
VBCR - April 2018, Vol 7, No 1 published on April 17, 2018 in Rheumatoid Arthritis
Stem-Cell Transplant Improves Survival in Patients with Severe Scleroderma
Alice Goodman
VBCR - April 2018, Vol 7, No 1 published on April 17, 2018 in Scleroderma
Treatment with Methotrexate Alone Yields Similar Outcomes to Combination Therapy in Early RA
Alice Goodman
VBCR - April 2018, Vol 7, No 1 published on April 17, 2018 in Rheumatoid Arthritis
Adalimumab Biosimilar Shown to Be Safe and Effective in Patients with RA
Alice Goodman
VBCR - April 2018, Vol 7, No 1 published on April 17, 2018 in Rheumatoid Arthritis
Noises In and Around Joint Signal Future Knee Osteoarthritis
Anne Rowe
VBCR - April 2018, Vol 7, No 1 published on April 17, 2018 in Osteoarthritis
Retired UK Professional Football Players at Higher Risk for Knee OA Than Men in the General Population
Anne Rowe
VBCR - December 2017, Vol 6, No 5 published on December 19, 2017 in Osteoarthritis
New Algorithm Shows Promise in Predicting Progression of Knee Osteoarthritis
Rebecca Bailey
VBCR - October 2017, Vol 6, No 4 published on October 20, 2017 in Osteoarthritis
Opioid Use Before Knee Replacement Surgery Leads to Worse Pain Outcomes
Anne Rowe
VBCR - August 2017, Vol 6, No 3 published on August 23, 2017 in Osteoarthritis
High-Fiber Diet Associated with Reduced Risk for Painful Knee Osteoarthritis
Anne Rowe
VBCR - August 2017, Vol 6, No 3 published on August 23, 2017 in Osteoarthritis
Early Treatment of Rheumatoid Arthritis Improves Functional Outcomes at 20 Years
Alice Goodman
VBCR - June 2017, Vol 6, No 2 published on June 29, 2017 in Rheumatoid Arthritis
Last modified: May 21, 2015
  • Rheumatology Practice Management
  • American Health & Drug Benefits
  • Value-Based Cancer Care
  • Value-Based Care in Myeloma
  • Value-Based Care in Neurology