These 2019 ACR/AF recommendations 22 for the management of OA are based on the best available evidence of benefit, safety, and tolerability of physical, educational, behavioral, psychosocial, mind-body, and pharmacologic interventions, as well as the consensus judgment of clinical experts. Either strong or conditional recommendations were made for or against the approaches evaluated. • Tibiofemoral knee braces are strongly recommended for patients with knee OA in whom disease in 1 or both knees is causing a sufficiently large impact on ambulation, joint stability, or pain to warrant use of an assistive device, and who are able to tolerate the associated inconvenience and burden associated with bracing. • Patellofemoral braces are conditionally recommended for patients with patellofemoral knee OA in whom disease in 1 or both knees is causing a sufficiently large impact on ambulation, joint stability, or pain to warrant use of an assistive device. The recommendation is conditional due to the variability in results across published trials and the difficulty some patients will have in tolerating the inconvenience and burden of these braces.
NICE 33 does not recommend the routine use of braces, however they do recommend braces in specific conditions which are often present in knee OA patients:
"Do not routinely offer insoles, braces, tape, splints or supports to people with osteoarthritis unless: • there is joint instability or abnormal biomechanical loading and • therapeutic exercise is ineffective or unsuitable without the addition of an aid or device and • the addition of an aid or device is likely to improve movement and function".
Made with FlippingBook - PDF hosting