Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials

Holden, M A; Murphy, M; Simkins, J; Thomas, M J; Huckfield, L; Quicke, J G; Halliday, N; Birrell, F N; Borrelli, B; Callaghan, M J; Dziedzic, K; Felson, D; Foster, N E; Ingram, C; Jinks, C; Jowett, S; Nicholls, E; Peat, G

Abstract

Objective
To identify and synthesise the content of knee bracing interventions in randomised controlled trials (RCTs) of knee osteoarthritis (OA).

Design
In this scoping review, three electronic databases (PubMed, Web of Science, Cochrane) were searched up to 10th June 2024. Nineteen previous systematic reviews of knee bracing for knee OA and four recent international clinical practice guidelines were also hand searched. Identified studies were screened for eligibility by two independent reviewers. Information on bracing interventions was extracted from included RCT reports, informed by Template for Intervention Description and Replication (TIDieR) guidelines. Data were synthesised narratively.

Results
Thirty-one RCTs testing 47 different bracing interventions were included. Braces were broadly grouped as valgus/varus, patellofemoral, sleeve, neutral hinged, or control/placebo knee braces. Brace manufacturer and models varied, as did amount of recommended brace use. Only three interventions specifically targeted brace adherence. Information on brace providers, setting, number of treatment sessions, and intervention modification over time was poorly reported. Adherence to brace use was described for 32 (68%) interventions, most commonly via self-report. Several mechanisms of action for knee braces were proposed, broadly grouped as biomechanical, neuromuscular, and psychological.

Conclusions
Many different knee brace interventions have been tested for knee OA, with several proposed mechanisms of action, a lack of focus on adherence, and a lack of full reporting. These issues may be contributing to the heterogeneous findings and inconsistent guideline recommendations about the clinical effectiveness of knee bracing for knee OA to date.

Citation

Holden, M. A., Murphy, M., Simkins, J., Thomas, M. J., Huckfield, L., Quicke, J. G., …Peat, G. (2024). Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials. Osteoarthritis and Cartilage, https://doi.org/10.1016/j.joca.2024.08.010

• Journal Article Type: Article
• Acceptance Date: Aug 23, 2024
• Online Publication Date: Aug 30, 2024
• Publication Date: 2024-08
• Deposit Date: Sep 13, 2024
• Journal: Osteoarthritis and Cartilage
• Print ISSN: 1063-4584
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.joca.2024.08.010
• Keywords: Scoping review, Osteoarthritis, Bracing, Knee
• Public URL: https://keele-repository.worktribe.com/output/920538
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1063458424013657?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials; Journal Title: Osteoarthritis and Cartilage; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.joca.2024.08.010; Content Type: article; Copyright: © 2024 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.