Review Article

Biomechanical Effect of Valgus Knee Braces on the Treatment of Medial Gonarthrosis: A Systematic Review

Table 3

Studies that evaluated the effect of knee brace on kinetic and kinematic parameters in medial gonarthrosis.

ReferencesType of braceSample sizeDurationStudy designOutcome measurementsResults

Arazpour et al. [26]Double-hinged brace (air cushions)7 P (5F/2M)Immediate effectWalkKAM
ROM
The KAM was significantly reduced. Knee ROM in sagittal plane was significantly decreased.
Brand et al. [27]Double-hinged brace22 P (10F/12M)2 weeksWalkKAM
GRF
Joint angle
The KAM and knee adduction angle were significantly reduced. The GRF was not significantly changed.
Brandon et al. [22]Single/double-hinged brace17 P (8F/9M)Immediate effectWalkKAM
Contact force
The KAM was not significantly changed unless the brace moment was included. The medial compartment load was significantly reduced.
Croce et al. [28]Single-hinged brace (air cushions)18 P (6F/12M)Immediate effectWalkKAMThe KAM decreased by 7.6% with the air cushion uninflated and decreased by 26.0% with the air cushion inflated to 7 psi.
Draganich et al. [29]Double-hinged brace10 P (-)4-5 weeksWalkKAM
Joint angle
The KAM was significantly reduced. The knee flexion angle was not significantly changed.
Ebert et al. [46]Double-hinged brace20 H (10F/10M)Immediate effectWalkKAMThe KAM was not significantly changed.
Fantini et al. [47]Single-hinged brace16 H (-)Immediate effectWalkKAM
KAI
The KAM was reduced during walking and running tasks. The KAI of 4° and 8° valgus mode were decreased by 25% and 36%, respectively.
Fantini et al. [48]Single-hinged brace11 P (8F/3M)2 weeksWalkKAM
KAI
The KAM was significantly reduced. Changes in KAI of 4° valgus and flexible adjustable were 29% and 15%, respectively.
Fesharaki et al. [30]Double-hinged brace (two-DOF)16 P (11F/5M)Immediate effectWalk
Sit-stand-sit
KAM
ROM
Shear force
The KAM was significantly reduced in walking. In the sit-to-stand test, the knee ROM was significantly reduced, and the shear force was decreased by  N.
Fesharaki et al. [24]Double-hinged brace (two-DOF)1 P (1M)Immediate effectSit-stand-sitShear forceThe shear force was decreased by 45 N.
Gaasbeek et al. [31]Single-hinged brace (air cushions)15 P (3F/12M)6 weeksWalkKAM
ROM
The KAM and ROM was significantly reduced.
Hall et al. [21]Single-hinged brace16 H (7F/9M)Immediate effectWalkContact force
KFM
KAM
The medial compartment load was not significantly changed. The KFM and KAM were significantly reduced.
Huber et al. [49]Double-hinged brace2 H (-)Immediate effectWalkJoint load
Brace force
Joint angle
The knee loads were significantly reduced. The device provided a supportive moment during stance. The knee extension angle was not changed.
Johnson et al. [32]Double-hinged brace10 P (4F/6M)3 monthsWalkKAMThe KAM was decreased by 0.23 Nm/kg.
Karimi et al. [33]Double-hinged brace5 P (-)Immediate effectWalkContact force
ROM
GRF
The mean values of peak knee contact force in the vertical and mediolateral directions, knee ROM, and GRF were not statistically changed.
Kim et al. [50]Single-hinged brace (control system)3 H (3M)Immediate effectWalkFoot pressureThe lateral-side foot pressure was significantly reduced during the stance phase.
Kutzner et al. [34]Single/double-hinged brace3 P (-)Immediate effectWalkContact forceThe medial forces were significantly reduced during walking, while the medial forces were reduced only with the MOS brace during ascending or descending stairs.
Lamberg et al. [35]Double-hinged brace15 P (3F/12M)2 weeks
8 weeks
WalkKAI
KAM
Joint angle
The KAI and KAM were significantly reduced. The peak knee extension angle during the stance phase was decreased.
Laroche et al. [36]Double-hinged brace20 P (16F/4M)5 weeksWalkKAM
Joint angle
KAI
The KAM was significantly reduced at the TS and PO phase. The knee internal/external rotation angle and KAI did not show any significant difference.
Marius et al. [51]Double-hinged braceSimulation analysisContact stressThe femoral cartilage stress, tibia cartilage stress, and menisci stress were significantly reduced.
Nagai et al. [52]Double-hinged brace10 P (2F/8M)2 weeksWalkGRFThe vertical compartment of GRF was not significantly changed.
Pollo et al. [37]Single-hinged brace11 P (-)>2 weeksWalkKAM
BAM
Joint loads
The KAM and the medial compartment load were significantly decreased by 13% and 11%, respectively. The maximum BAM was 11.0 Nm when the brace set to 8° valgus mode.
Reinsdorf et al. [25]Single-hinged brace (control system)1 H (-)Immediate effectWalkBAMThe peak BAM was 8.7 Nm, and the maximum raise of BAM was 37 Nm/s during 0-15% GC.
Schmalz et al. [38]Single-hinged brace16 P (8F/8M)4 weeksWalkBAM
GRF
The maximum BAM was 0.05 Nm/kg, which represents approximately 10% of the natural KAM. The vertical compartment of the GRF was decreased, but the horizontal force was increased by 16.4% BW.
Segal et al. [53]Single-hinged brace15 P (9F/6M)Immediate effectStatic standingContact stress
Contact area
The mean contact stress and contact area of the medial compartment were not significantly changed during the 5°–10° and 15°-20° flexion conditions.
Self et al. [54]Single-hinged brace5 P (1F/4M)2 weeksWalkKAM
Brace force
The KAM was significantly reduced at 20% and 25% of stance phase. The valgus force remained constant throughout the first 80% of the stance phase.
Shriram et al. [55]1 H (1M)WalkContact force
Contact area
The total contact force, contact area, and contact pressure of the medial and lateral compartment were significantly changed.
Toriyama et al. [39]Single-hinged brace19 P (17F/2M)Immediate effectWalkKAM
KFM
Joint angle
The KFM and KAM were significantly reduced. During 46%-55% of the stance phase, the knee adduction angle was significantly increased by an average of 0.32°.

P: patient; F: female; M: male; H: healthy; (-): not mentioned; GC: gait cycle; BW: body weight; GRF: ground reaction force; DOF: degree-of-freedom; KAM: knee adduction moment; KFM: knee flexion moment; KAI: knee adduction impulse; TS: terminal stance; PO: push-off; BAM: brace abduction moment.