Evaluating the effectiveness of valgus knee braces in improving pain, stiffness, and physical function in medial...

Valgus knee orthosis is a common conservative treatment for medial compartment knee osteoarthritis (OA), though its efficacy in diverse socioeconomic and cultural contexts remains understudied. This investigation evaluated the short-term effects of a valgus knee orthosis on knee OA patients from a developing country, while monitoring adherence, to address this gap in the literature. The study included 35 participants with radiographically confirmed OA (Kellgren-Lawrence grades 2-3). The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index tool was used to assess participants. All participants utilized the Össur Unloader One orthosis, which was equipped with an integrated activPAL sensor to monitor adherence during a 2-week intervention period. WOMAC index demonstrated statistically significant improvement, with mean scores decreasing from 0.67 (0.15) to 0.42 (0.18) at 1 week ( P  < 0.001) and to 0.32 (0.16) at 2 weeks ( P  < 0.001) of wearing the orthosis. Notably, after 2 weeks, 86% of participants exceeded established minimal clinically important difference thresholds. ActivPAL data for adherence revealed a significant positive correlation between brace wearing time and clinical improvement ( P  = 0.008), with participants achieving ≥8 h daily wear time exhibiting the best outcomes (51% improvement in WOMAC index). The findings shed light on the possible usefulness of valgus knee orthosis in controlling symptoms of knee OA patients from resource-variable settings with unique cultural habits (i.e. kneeling and floor-sitting behaviors) while highlighting the critical role of adherence monitoring.