Methods for evaluating effects of unloader knee braces on joint health: a review

Abstract

The paper aims to provide a state-of-the-art review of methods for evaluating the effectiveness and effect of unloader knee braces on the knee joint and discuss their limitations and future directions. Unloader braces are prescribed as a non-pharmacological conservative treatment option for patients with medial knee osteoarthritis to provide relief in terms of pain reduction, returning to regular physical activities, and enhancing the quality of life. Methods used to evaluate and monitor the effectiveness of these devices on patients' health are categorized into three broad categories (perception-, biochemical-, and morphology-based), depending upon the process and tools used. The main focus of these methods is on the short-term clinical outcome (pain or unloading efficiency). There is a significant technical, research, and clinical literature gap in understanding the short- and long-term consequences of these braces on the tissues in the knee joint, including the cartilage and ligaments. Future research directions may complement existing methods with advanced quantitative imaging (morphological, biochemical, and molecular) and numerical simulation are discussed as they offer potential in assessing long-term and post-bracing effects on the knee joint.

Keywords: Finite element modelling; Knee osteoarthritis; Post-bracing effects; Quantitative imaging; Unloader knee brace.

Conflict of interest statement

The authors declare that they have no competing interests.This article does not contain any studies with human participants or animals performed by any of the authors.

Figures

Fig. 1

Effect of OA on Knee Joint. a Healthy knee joint; b narrow joint space along the medial; c force acting by the unloader brace using three-point loading mechanism

Fig. 2

Knee physiology. Effects of unloader braces on knee health

Fig. 3

Evaluation methodology. Schematic representation clinical procedures to measure the effectiveness of unloader braces on the joint