Knee bracing may provide small improvements in patient-reported outcomes in knee osteoarthritis

1. Adding compartment-specific knee bracing with an adherence support intervention to standard advice, information and exercise (AIE) provides a small but meaningful improvement in patient-reported outcomes in adults with knee osteoarthritis. 

Evidence Rating Level: 1 (Excellent) 

Painful knee osteoarthritis, affecting 365 million adults, presents a major challenge to health. Primary knee arthroplasty, though effective, is still quite invasive, with preventative and non-surgical interventions being explored. Knee bracing is one such treatment, contradicting recommendations and limited evidence from high-quality trials restrict its proliferation. The Provision of Braces for Patients with Knee Osteoarthritis (PROP OA) was designed to be a large, randomized trial examining whether the addition of bracing was better than advice, information, and exercise alone. 466 participants were enrolled in the study, aged 45 and up, experiencing moderate to severe knee pain during weight-bearing activity, with the Knee Osteoarthritis Outcomes Score (KOOS)-5 being analyzed at 3, 6 and 12 months. Greater improvements in KOOS-5 scores were seen in the knee brace addition group at 6 months (adjusted mean difference 3.39, 95% CI 0.96 to 5.82; effect size 0.24), with similar findings at 3 months (adjusted mean difference 3.67, 95% CI 1.47 to 5.87; effect size 0.26). However, at 12 months, the results were no longer statistically significant (adjusted mean difference 2.67, 95% CI −0.24 to 5.57; effect size 0.19). Some adverse events experienced included skin irritation, soreness and blisters. Another factor to consider was the additional time with physiotherapists in the group with brace intervention. Overall, while some small improvements were seen at 3 and 6 months with the addition of a knee brace to advice, information and exercise to the group without a brace, by 12 months the results were no longer significant.

Click here to read this study in BMJ

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