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- DOI: 10.1016/j.joca.2011.03.003
- PMID: 21397707
- UKPMCID: 21397707
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The effect of a patellar brace on three-dimensional patellar kinematics in patients with lateral patellofemoral osteoarthritis.
McWalter, E J; Hunter, D J; Harvey, W F; McCree, P; Hirko, K A; Felson, D T; Wilson, D R
Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2011;19(7):801-808.
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Full-text held externally
- DOI: 10.1016/j.joca.2011.03.003
- PMID: 21397707
- UKPMCID: 21397707
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 0.46mm medially (P<0.001), tilt 1.17° medially (P<0.001), spin 0.62° externally (P=0.012) and translate 1.09mm distally (P<0.001) and 0.47mm 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.