Save
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. May 9, 2018; 209659; P11-1042 Topic: Knee
Kirsten Bettina Jensen
Kirsten Bettina Jensen
This content is reserved for ESSKA members. Login or become a member here

You can access free non-premium educational content on the ESSKA Academy Portal by registering for free as 'ESSKA Academy User' here
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
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings