Knee Braces for Osteoarthritis Treatment

Knee braces found to reduce pain and amount of bone marrow damage in osteoarthritis treatment

(RxWiki News) Osteoarthritis is the most common joint issue for middle-aged and older adults. The good news is that there may be a simple solution to help patients deal with the pain.

A recent study examined the effectiveness of wearing a patellofemoral (the joint connecting the back of the knee cap and the thigh bone) knee brace for reducing knee pain and damaged bone marrow (tissue inside the bones).

The researchers found that wearing a knee brace significantly decreased joint pain and bone marrow damage in the patellofemoral joint.

They concluded that a knee brace is an effective tool to decrease pain in patellofemoral osteoarthritis (damage to cartilage in the joints) without medication.

"Discuss any knee pain with your doctor."

The lead author of this study was David T. Felson, MD, MPH, from the Arthritis Research UK Epidemiology Unit in the School of Translational Medicine, of the Musculoskeletal Research Group at the University of Manchester in Manchester, UK.

The study included 126 osteoarthritis patients between the ages of 40 and 70 years old. The Kellgren/Lawrence scale (KL) was used to assess patients' level of osteoarthritis. The KL scale goes from 0 (no disease) to 4 (severe osteoarthritis).

All participants had either KL grade 2 (bony projections formed along the edge of bones where they join together and possibly narrowing of joint space) or grade 3 (many bony projections, definite narrowing of joint space, possible deformity of bone ends, and abnormal hardening of body tissue) patellofemoral osteoarthritis (OA).

Fifty-seven of the participants were female, and the average age was 55.5 years old.

The researchers gave the participants questionnaires at the beginning and end of the six week study period that measured their symptoms, level of pain and joint tenderness.

Pain was measured by the Visual Analog Scale pain scale—a questionnaire that asks patients to choose from different ranges of possibilities from “no pain” to “worst pain imaginable,” and for pain frequency of “everyday” to “never.” The average pain score at first examination was 64.6.

The researchers also gave the participants MRI scans at the beginning and end of the study period to measure how much bone marrow damage they had. Ninety of the participants were found to have patellofemoral bone marrow lesions (internal bruises) at the beginning of the study.

Patellofemoral bone marrow lesions happen when there is too much stress on the knee joint. They are directly related to the level of pain felt. The researchers used the change in the volume of the bone marrow lesions to measure how effective wearing a knee brace was for treating patellofemoral OA.

The participants were then given a knee brace to wear during the six week study period; braces were worn for an average of 7.4 hours per day. There was also a control group that did not wear a brace.

The researchers found that the participants who used the brace had significantly reduced pain in their patellofemoral joint by the end of the six weeks. The average pain score in the brace group went down by 18.16 points to 46.44.

The control group only experienced an average decrease of 1.29 points, bringing their average pain score down to 63.11.

The findings also revealed that the bracing group had a reduction of the volume of bone marrow lesions at the end of the study period. This group experienced an average decrease of 554.92 mm3, whereas the control group ended up with an average of 102.66 mm3 increase in bone marrow lesion volume.

Ultimately, the researchers concluded that using a knee brace is an effective method to help treat patellofemoral OA, especially because there is a large need for treatments that do not use medications which can often have unwanted side effects.

This study will be presented during the American College of Rheumatology Annual Meeting on October 28.

Review Date: 
October 25, 2013