The effects of a sleeve knee brace during stair negotiation in patients with symptomatic patellofemoral osteoarthritis

Abstract

Background: The patellofemoral joint is an important source of pain in knee osteoarthritis. Most biomechanical research in knee osteoarthritis has focused on the tibiofemoral joint during level walking. It is unknown what happens during stair negotiation in patients with patellofemoral joint osteoarthritis, a task commonly increasing pain. Conservative therapy for patellofemoral joint osteoarthritis includes the use of a sleeve knee brace. We aimed to examine the effect of a sleeve knee brace on knee biomechanics during stair negotiation in patellofemoral joint osteoarthritis patients.

Methods: 30 patellofemoral joint osteoarthritis patients (40-70 years) ascended and descended an instrumented staircase with force plates under two conditions - wearing a Lycra flexible knee support (Bioskin Patellar Tracking Q Brace) and no brace (control condition). Knee joint kinematics (VICON) and kinetics were recorded.

Findings: During stair ascent, at the knee, the brace significantly reduced the maximal flexion angle (2.7⁰, P = 0.002), maximal adduction angle (2.0⁰, P = 0.044), total sagittal range of motion (2.0⁰, P = 0.008), total frontal range of motion (1.7⁰, P = 0.023) and sagittal peak extension moment (0.05 Nm/kg, P = 0.043) compared to control. During stair descent, at the knee, the brace significantly reduced the maximal flexion angle (1.8⁰, P = 0.039) and total sagittal range of motion (1.5⁰, P = 0.045) compared to control.

Interpretation: The small changes in knee joint biomechanics during stair negotiation observed in our study need to be investigated further to help explain mechanisms behind the potential benefits of a sleeve knee brace for painful patellofemoral joint osteoarthritis.

Keywords: Bracing; Knee; Osteoarthritis; Patellofemoral; Stair negotiation.