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...
| Publicado en: | Acta Orthopaedica Vol. 96; pp. 102 - 110 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Medical Journals Sweden AB
2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191461340&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191461340 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2025 vid: 96 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 191461340 191461340 191461340 10.2340/17453674.2025.42846 191461340 ppf: 102 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Unloader brace or high tibial osteotomy in the treatment of the young patient with medial knee osteoarthritis: a randomized controlled trial. aug: au: STAM, Mark VERSCHUEREN, Joost VAN OUTEREN, Mark V. BROUWER, Reinoud W. GAASBEEK, Robert D. A. BLENDEA, Sorin G. VAN ES, Eline M. REIJMAN, Max BIERMA-ZEINSTRA, Sita M. A. affil: Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre Rotterdam. sug: subj: Osteoarthritis, Knee Therapy Osteoarthritis, Knee Surgery Tibia Surgery Osteotomy Methods Orthoses Utilization Treatment Outcomes Pain Measurement Functional Assessment Postoperative Complications Quality of Life Human Male Female Funding Source Adolescence Adult Middle Age Aged Netherlands Multicenter Studies Randomized Controlled Trials Random Assignment Comparative Studies Clinical Assessment Tools Scales Knee Radiography Multiple Linear Regression Descriptive Statistics Data Analysis Software Orthoses Adverse Effects Hypesthesia Surgical Wound Infection Postoperative Hemorrhage Arthroplasty, Replacement, Knee Analgesics, Opioid Therapeutic Use Activities of Daily Living Sports Participation Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: 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. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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