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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Publicado en:Acta Orthopaedica Vol. 96; pp. 102 - 110
Autores principales: 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.
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Medical Journals Sweden AB 2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2025
      vid: 96
      pid: 59195
      pub: Medical Journals Sweden AB
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        10.2340/17453674.2025.42846
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        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
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