Preoperative testing of the knee with unicompartmental unloading by a ROM-brace
Author(s):
Jensen Kirsten Bettina (Denmark)
,
Jensen Kirsten Bettina (Denmark)
Affiliations:
Rathcke M.
,
Rathcke M.
Affiliations:
Warming Susan
,
Warming Susan
Affiliations:
Krogsgaard M.
Krogsgaard M.
Affiliations:
ESSKA Academy. Jensen K. 05/09/18; 209659; P11-1042 Topic: G1 - Medial unicompartmental arthroplasty
Kirsten Bettina Jensen
Kirsten Bettina Jensen
Login now to access Regular content available to all registered users.

You can access free regular educational content on the ESSKA Academy by registering as an 'ESSKA Academy User’ here

Access to Premium content is currently a membership benefit.

Click here to join ESSKA or renew your membership.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Objectives: The cause and localization of persistent knee pain in younger patients with multiple previous operations, is often obscure. It is important to locate pain to one compartment, when considering implantation of a meniscus allograft, a viable osteochondral allograft or other unicompartment surgery. We have tested these patients with an unloader brace for 4-6 weeks before the indication for surgery is established. A positive effect on pain of bracing supports the indication for surgery.

To evaluate if the unicompartmental unloader is a useful tool in the decision-making related to unicompartmental knee surgery.

Methods: Prospective patients 2013-16 who had undergone multiple knee surgeries (median 4, IQR 2-5) and were considered for additional, unicompartmental surgery, had an unloader brace for 4-6 weeks. They were evaluated with the numeric rank scale (NRS) for pain, and the knee injury and osteoarthritis outcome score (KOOS), before and after a period of 4-6 weeks using the off-loading brace. Bracing and instructions were given by the physiotherapist, and all evaluations were done by the patients.

Results: Thirteen patients (10 female / 3 male) with a median age of 24 years (IQR 22-28) participated. The unloader brace had been used for median 38 days (IQR 32 - 53) at follow-up.
Significant improvements were seen in all patients for all parameters, supporting the indication for further surgery:
Baseline, median (IQR)/Follow-up, median (IQR)
NRS at rest3 (3-4)/2 (1-2,75)p*0,003
NRS at activity8 (8-8)/3,5 (2,25-5)p*0,002
KOOS pain48,5 (37,5-64)/78 (66,75-87,5)p*0,002
KOOS symp69,5 (54,75-86)/87,5 (68,75-93)p*0,002
KOOS ADL62,5 (55,5-75,5)/84,5 (73,25-96)p*0,002
KOOS sport12,5 (5-28,75)/47,5 (13,25-72,5)p*0,003
KOOS QOL25 (14,5-31) /32 (25-38)/0,017)p*,0,017

p*=p-value: Wilcoxon signed ranks test

Conclusions: This procedure is useful during the evaluation of complex cases of knee pain and useful for establishing the indication for surgery.

Keywords:
kneebracing, younger patients ,pain to one compartment,unicompartment surgery
Objectives: The cause and localization of persistent knee pain in younger patients with multiple previous operations, is often obscure. It is important to locate pain to one compartment, when considering implantation of a meniscus allograft, a viable osteochondral allograft or other unicompartment surgery. We have tested these patients with an unloader brace for 4-6 weeks before the indication for surgery is established. A positive effect on pain of bracing supports the indication for surgery.

To evaluate if the unicompartmental unloader is a useful tool in the decision-making related to unicompartmental knee surgery.

Methods: Prospective patients 2013-16 who had undergone multiple knee surgeries (median 4, IQR 2-5) and were considered for additional, unicompartmental surgery, had an unloader brace for 4-6 weeks. They were evaluated with the numeric rank scale (NRS) for pain, and the knee injury and osteoarthritis outcome score (KOOS), before and after a period of 4-6 weeks using the off-loading brace. Bracing and instructions were given by the physiotherapist, and all evaluations were done by the patients.

Results: Thirteen patients (10 female / 3 male) with a median age of 24 years (IQR 22-28) participated. The unloader brace had been used for median 38 days (IQR 32 - 53) at follow-up.
Significant improvements were seen in all patients for all parameters, supporting the indication for further surgery:
Baseline, median (IQR)/Follow-up, median (IQR)
NRS at rest3 (3-4)/2 (1-2,75)p*0,003
NRS at activity8 (8-8)/3,5 (2,25-5)p*0,002
KOOS pain48,5 (37,5-64)/78 (66,75-87,5)p*0,002
KOOS symp69,5 (54,75-86)/87,5 (68,75-93)p*0,002
KOOS ADL62,5 (55,5-75,5)/84,5 (73,25-96)p*0,002
KOOS sport12,5 (5-28,75)/47,5 (13,25-72,5)p*0,003
KOOS QOL25 (14,5-31) /32 (25-38)/0,017)p*,0,017

p*=p-value: Wilcoxon signed ranks test

Conclusions: This procedure is useful during the evaluation of complex cases of knee pain and useful for establishing the indication for surgery.

Keywords:
kneebracing, younger patients ,pain to one compartment,unicompartment surgery
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies