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In older adults, knee osteoarthritis (OA) is a common trigger of pain and disability. Knee braces may help reduce symptoms by providing support and unloading affected joint compartments.
Patients with knee osteoarthritis experience modest gains in pain relief and reported outcomes when compartment-specific knee bracing is integrated into a standard exercise and education program.
In older adults, knee osteoarthritis (OA) is a common trigger of pain and disability. Knee braces may help reduce symptoms by providing support and unloading affected joint compartments. However, evidence for their potency in routine clinical practice remains limited. The PROP OA trial evaluated whether the addition of compartment-specific knee bracing and an adherence intervention to standard advice, written information, and exercise instruction (AIE) improves outcomes compared with AIE alone.
The study was a multicentre, parallel-group, superiority, statistician-blinded, randomized controlled trial. Adults (aged >45 years) with symptomatic knee OA were randomly segregated 1:1 to get either:
Volunteers in the AIE+B group also received a two-week follow-up consultation, brief motivational interviewing, and targeted text-message reminders to encourage brace adherence. The key endpoint was the composite Knee Osteoarthritis Outcome Score (KOOS)-5 (0–100 scale) at 6 months. Secondary endpoints included KOOS-5 at 3 and 12 months, KOOS subscale scores, and pain during weight-bearing activities.
A total of 466 subjects were randomized. The mean age was 64 ± 9 years, and 46% were women. Follow-up with analyzable data was available for:
At the primary 6-month assessment, the AIE+B group illustrated greater improvement in KOOS-5 when compared with the AIE group (Table 1).
Among adults with knee OA, integrating compartment-specific knee bracing and an adherence support intervention to advice, written information, and exercise instruction elicited small but prominent improvements in patient-perceived outcomes, particularly pain. Although the benefits diminished over time, the intervention proved to be safe and may serve as a valuable non-pharmacological treatment option.
BMJ
Provision of knee bracing for knee osteoarthritis (PROP OA): multicentre, parallel group, superiority, statistician blinded, randomised controlled trial
Melanie A Holden et al.
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