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Osteoarthritis Cartilage. 2011 Jul;19(7):801-8. doi: 10.1016/j.joca.2011.03.003. Epub 2011 Mar 11.

The effect of a patellar brace on three-dimensional patellar kinematics in patients with lateral patellofemoral osteoarthritis.

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  • 1Department of Mechanical Engineering, University of British Columbia, Canada.

Abstract

OBJECTIVE:

Patellar bracing is a mechanical treatment strategy for patellofemoral osteoarthritis (OA) that aims to unload the lateral compartment of the joint by translating the patella medially. Our objective was to determine whether a patellar brace can correct patellar kinematics in patients with patellofemoral OA.

DESIGN:

We assessed the effect of a patellar brace on three-dimensional patellar kinematics (flexion, spin and tilt; proximal, lateral and anterior translation) at sequential, static knee postures, using a validated magnetic resonance imaging (MRI)-based method, in 19 patients with radiographic lateral patellofemoral OA. Differences in kinematics between unbraced and braced conditions were assessed in the unloaded and loaded knee (15% bodyweight load) using hierarchical linear random-effects models. Random slope and quadratic terms were included in the model when significant (P<0.05).

RESULTS:

Bracing with load caused the patellae to translate 0.46 mm medially (P<0.001), tilt 1.17° medially (P<0.001), spin 0.62° externally (P=0.012) and translate 1.09 mm distally (P<0.001) and 0.47 mm anteriorly (P<0.001) over the range of knee flexion angles studied. Bracing also caused the patellae to extend in early angles of knee flexion (P<0.001). The brace caused similar trends for the unloaded condition, though magnitudes of the changes varied.

CONCLUSION:

Bracing changed patellar kinematics, but these changes did not appear large enough to be clinically meaningful because no reduction in pain was observed in the parent study.

Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

PMID:
21397707
[PubMed - indexed for MEDLINE]
PMCID:
PMC3133818
Free PMC Article
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