Evidence-based Use of Knee Braces and Orthotics

 

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Orthotics are used to manage a wide spectrum of knee disorders in the nonoperative, preoperative, and postoperative settings. While they are routinely prescribed and generally regarded to be safe and effective, much of the current evidence regarding indications, functional mechanisms, and direct benefits to patients is often based on white papers, commercial brochures, and company representative training materials. While these sources provide some valuable and applicable information and are unlikely to result in harm to patients, they do not optimize evidence-based decision-making for the use of orthotics in practice.

To begin to address this gap in orthopaedic health care, this special issue of The Journal of Knee Surgery contains five articles covering each of the major categories for orthotics use among knee surgeons. Each of the articles is written by experts in the field, who focused their efforts on providing available peer-reviewed evidence to address key clinical questions regarding targeted orthotics, including the following:

• What indications and patients are the orthotics intended for? What are the contraindications?

• What functional mechanisms are proposed? Which of them are proven?

• What peer-reviewed data are available regarding mechanisms, safety, and efficacy?

• Do they “really work” in practice? If so, how?

• Should we use them? If so, when?

In addition, to provide contemporary data for the current era of value-based care, each article also addresses considerations of cost-effectiveness to include factors of adherence to brace use, the health care team's roles in orthotic choice and use, and patient satisfaction metrics.

I am very grateful to all of the authors for pouring their time and expertise into these articles to provide this evidence-based guide for orthotics use in the knee. As you will see when reading these informative articles, there is still much to be done in terms of providing robust data for clear decision-making regarding indications and patient selection, patient and provider adherence to prescribed uses, risks and benefits, and cost-effectiveness for each of the orthotics used. However, these articles provide a rich and pragmatic resource for practitioners to know what can and cannot be considered current evidence-based use of these valuable tools for managing patients.

Publication History

Article published online:
11 February 2022

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