A meta-analysis of six randomized clinical trials undertaken to determine the effects of valgus knee bracing on pain, function, compliance, and complications in patients with medial knee osteoarthritis (OA) found that bracing resulted in small-to-moderate improvements in pain. Researchers at the University of Western Ontario, London, Canada, searched seven databases from their inception to January 2014 to compare changes in patient-reported pain and/or function in patients with medial knee OA. The results of the study were published September 8 in the journal Arthritis Care & Research.
Of the six clinical trials included, two reviewers independently determined study eligibility, rated risk of bias, and extracted data. Pooled estimates and 95 percent confidence intervals (CI) for standardized mean differences (SMD) for the improvement in pain and function were calculated. Event rates were calculated for studies that reported complications. The research team concluded that there was a statistically significant difference favoring the valgus brace group for improvement in pain and function. When compared to a control group that did not use an orthosis, the effect size was moderate for pain and function. When compared to a control group that used a control orthosis, only a small, statistically significant effect for pain remained. Instructions for brace use varied considerably and compliance ranged from 45 to 100 percent. Up to 25 percent of patients reported minor complications with brace use. The researchers noted that the effect sizes vary based on study design and warrant future research.
