Bracing for Patellofemoral Osteoarthritis

NCT ID: NCT02984254

Last Updated: 2019-01-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-20

Study Completion Date

2018-12-30

Brief Summary

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BACKGROUND: Despite the prevalence of patellofemoral ostearthritis (OA), this joint has received relatively little attention in the OA literature and there are few treatment options for individuals with patellofemoral OA. Patellar misalignment is associated with radiographic progression patellofemoral OA and symptoms and in magnetic resonance imaging (MRI), to cartilage loss measurements and bone marrow lesions. The hypothesis is that the correction of the patella disorder using strategies such as bracing or adhesive bandages can handle the symptoms and progression of OA.

OBJECTIVE: To compare the effect of a brace designed to stabilize the patellofemoral joint compared with a neoprene sleeve with kneecap opening in patients with patellofemoral OA.

METHODS: Fifty-two patients with patellofemoral OA and co-morbidities (Two or more of: overweight or obesity, hyperglycemia, dyslipidemia, hyperuricemia, high blood pressure) will be divided into two groups according to the knee brace that will receive: Functional Bracing patellofemoral (group 1) and neoprene knee sleeve with patella opening (group 2). Both groups will be oriented on the clinical treatment of osteoarthritis and metabolic syndrome and asked to do daily exercises in addition to reporting the daily consumption of drugs a month before placing the orthotics up to three months after placing it. They will be evaluated with the questionnaires WOMAC and Lequesne, and asked to perform the five-times-sit-to-stand-test, Timed-up-and-go (TUG) and the six-minute walk test in the moments immediately prior to placement of the brace, with one, three and after 12 months bracing.

Detailed Description

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All patients that sign the informed consent will be randomized and asked to participate in a 4-hour course about knee osteoarthritis. They will be sent home with a form to fill in all medications consumed daily for a month. They will return to the hospital where according to data given by www.randomization.com, they will receive one of two braces in one or both knees depending on their symptoms.

The functional brace has medial, lateral, superior and inferior "ruber bands" that should center patella in the patella groove. The other traditional neoprene sleeve brace with a patellar opening also tries to do the same with no other reinforcement other than the neoprene sleeve.

Prior to bracing, patients will deliver the prior month medication form, answer WOMAC and Lequesne questionnaires, and perform TUG, FTSST and the six-minute walk test.

They will be instructed to use the brace for 2 hours in the first day increasing half an hour per day up to a maximum of 12 hours/day. In case of difficulties with the brace for 12 continuous hours, they will be allowed to use it for at least 4 hours with a 2 hours interval and then again returning to bracing. Patients should sleep/rest without the brace(s). They should use their braces during physical activities unless if under water.

The primary objective is to evaluate and compare the short-term benefits of knee stabilization and compression. Therefore, the follow-up assessments, will be made prior to bracing and after one and three months. The evaluation will include the delivery of the registration of medications consumed daily (along with the hours of use of the orthosis), the WOMAC and Lequesne questionnaires and functional evaluations. X-rays without the braces (Front Schuss, profile and Axial) for measurement of affected joint spaces will be made before inclusion and after one year. Panoramic X-rays of the lower limbs will be performed before inclusion to measure the internal and external femoral-tibial angle. Complaints (pain, slip, swelling, skin lesions) and satisfaction (decrease pain, mobility improvement) with the use of the brace will be sought at each encounter. Patients will be asked about their weekly physical activity (intensity, type and hours of physical activity) on any adverse effects when using orthotics. Weight and height will be measured and each assessment to calculate BMI.

The secondary objective is the improvement in pain, stiffness and long-term function (1 year). Therefore, after a brief analysis of the results of three months, if there is a clinically significant difference between the groups, all patients will use the brace with best results. Therefore the study will be a case series. If both groups show clinically relevant improvements with no significant differences between the orthotics, the study will remain with two arms and the same clinical assessments, questionnaires, functional and radiographic one year. If none of the groups show a clinically relevant improvement in three months, the study will be terminated. Adverse effects of the use of orthotics will also be recorded in the one-year visit. All patients will be advised to discontinue use of the braces and telephone to our secretary in case of any adverse effects in the period between the official evaluations for proper conduct.

Conditions

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Knee Osteoarthritis Metabolic Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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functional patellofemoral neoprene brace

26 Patients will use a a functional patellofemoral neoprene brace and answer WOMAC, Lequesne questionnaires, perform Timed-up-and-go (TUG), five-times-sit-to-stand-test (FTSST) and the six-minute walk test.

Group Type EXPERIMENTAL

Womac

Intervention Type DEVICE

Answer Womac questionnaires at baseline, 1 month, 3 months and 1 year

Lequesne

Intervention Type DEVICE

Answer Lequesne questionnaires at baseline, 1 month, 3 months and 1 year

Timed-up-and-go (TUG)

Intervention Type DEVICE

Perform Timed-up-and-go (TUG) at baseline, 1 month, 3 months and 1 year

five-times-sit-to-stand-test (FTSST)

Intervention Type DEVICE

Perform the five-times-sit-to-stand-test (FTSST) at baseline, 1 month, 3 months and 1 year

Six-minute walk test.

Intervention Type DEVICE

Perform six-minute walk test at baseline, 3 months and 1 year

functional patellofemoral neoprene brace

Intervention Type DEVICE

Use the functional patellofemoral neoprene brace for 2 hours/day minimum - 12 hours/day maximum

neoprene sleeve brace.

26 Patients will use a neoprene sleeve brace and answer WOMAC, Lequesne questionnaires, perform Timed-up-and-go (TUG), five-times-sit-to-stand-test (FTSST) and the six-minute walk test.

Group Type EXPERIMENTAL

Womac

Intervention Type DEVICE

Answer Womac questionnaires at baseline, 1 month, 3 months and 1 year

Lequesne

Intervention Type DEVICE

Answer Lequesne questionnaires at baseline, 1 month, 3 months and 1 year

Timed-up-and-go (TUG)

Intervention Type DEVICE

Perform Timed-up-and-go (TUG) at baseline, 1 month, 3 months and 1 year

five-times-sit-to-stand-test (FTSST)

Intervention Type DEVICE

Perform the five-times-sit-to-stand-test (FTSST) at baseline, 1 month, 3 months and 1 year

Six-minute walk test.

Intervention Type DEVICE

Perform six-minute walk test at baseline, 3 months and 1 year

neoprene sleeve brace.

Intervention Type DEVICE

Use the neoprene sleeve brace for 2 hours/day minimum - 12 hours/day maximum

Interventions

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Womac

Answer Womac questionnaires at baseline, 1 month, 3 months and 1 year

Intervention Type DEVICE

Lequesne

Answer Lequesne questionnaires at baseline, 1 month, 3 months and 1 year

Intervention Type DEVICE

Timed-up-and-go (TUG)

Perform Timed-up-and-go (TUG) at baseline, 1 month, 3 months and 1 year

Intervention Type DEVICE

five-times-sit-to-stand-test (FTSST)

Perform the five-times-sit-to-stand-test (FTSST) at baseline, 1 month, 3 months and 1 year

Intervention Type DEVICE

Six-minute walk test.

Perform six-minute walk test at baseline, 3 months and 1 year

Intervention Type DEVICE

functional patellofemoral neoprene brace

Use the functional patellofemoral neoprene brace for 2 hours/day minimum - 12 hours/day maximum

Intervention Type DEVICE

neoprene sleeve brace.

Use the neoprene sleeve brace for 2 hours/day minimum - 12 hours/day maximum

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with symptomatic knee OA (patellofemoral)

Exclusion Criteria

* Not using the brace as requested;
* Study abandonment;
* No adaptation to brace;
* Skin and vascular complications by use of the brace;
* Failure to complete the consumption of drugs between inclusion and bracing;
* Obesity class II, III or morbid;
* Patients who cannot read or understand the informed consent or the WOMAC questionnaire;
Minimum Eligible Age

30 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Marcia Uchoa Rezende

MD; PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marcia U Rezende, MD; PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Orthopedics and Traumatology - Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

References

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Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006 Nov;33(11):2271-9. Epub 2006 Oct 1.

Reference Type BACKGROUND
PMID: 17013996 (View on PubMed)

McAlindon T, Zhang Y, Hannan M, Naimark A, Weissman B, Castelli W, Felson D. Are risk factors for patellofemoral and tibiofemoral knee osteoarthritis different? J Rheumatol. 1996 Feb;23(2):332-7.

Reference Type BACKGROUND
PMID: 8882042 (View on PubMed)

Hunter DJ, Zhang YQ, Niu JB, Felson DT, Kwoh K, Newman A, Kritchevsky S, Harris T, Carbone L, Nevitt M. Patella malalignment, pain and patellofemoral progression: the Health ABC Study. Osteoarthritis Cartilage. 2007 Oct;15(10):1120-7. doi: 10.1016/j.joca.2007.03.020. Epub 2007 May 14.

Reference Type BACKGROUND
PMID: 17502158 (View on PubMed)

Kalichman L, Zhang Y, Niu J, Goggins J, Gale D, Felson DT, Hunter D. The association between patellar alignment and patellofemoral joint osteoarthritis features--an MRI study. Rheumatology (Oxford). 2007 Aug;46(8):1303-8. doi: 10.1093/rheumatology/kem095. Epub 2007 May 24.

Reference Type BACKGROUND
PMID: 17525117 (View on PubMed)

Hinman RS, Bennell KL, Crossley KM, McConnell J. Immediate effects of adhesive tape on pain and disability in individuals with knee osteoarthritis. Rheumatology (Oxford). 2003 Jul;42(7):865-9. doi: 10.1093/rheumatology/keg233. Epub 2003 Mar 31.

Reference Type BACKGROUND
PMID: 12730546 (View on PubMed)

Hinman RS, Crossley KM, McConnell J, Bennell KL. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ. 2003 Jul 19;327(7407):135. doi: 10.1136/bmj.327.7407.135.

Reference Type BACKGROUND
PMID: 12869456 (View on PubMed)

Cushnaghan J, McCarthy C, Dieppe P. Taping the patella medially: a new treatment for osteoarthritis of the knee joint? BMJ. 1994 Mar 19;308(6931):753-5. doi: 10.1136/bmj.308.6931.753.

Reference Type BACKGROUND
PMID: 8142829 (View on PubMed)

Crossley KM, Marino GP, Macilquham MD, Schache AG, Hinman RS. Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis? Arthritis Rheum. 2009 Dec 15;61(12):1719-25. doi: 10.1002/art.24872.

Reference Type BACKGROUND
PMID: 19950307 (View on PubMed)

McWalter EJ, Hunter DJ, Harvey WF, McCree P, Hirko KA, Felson DT, Wilson DR. The effect of a patellar brace on three-dimensional patellar kinematics in patients with lateral patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2011 Jul;19(7):801-8. doi: 10.1016/j.joca.2011.03.003. Epub 2011 Mar 11.

Reference Type BACKGROUND
PMID: 21397707 (View on PubMed)

Hunter DJ, Harvey W, Gross KD, Felson D, McCree P, Li L, Hirko K, Zhang B, Bennell K. A randomized trial of patellofemoral bracing for treatment of patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2011 Jul;19(7):792-800. doi: 10.1016/j.joca.2010.12.010. Epub 2011 Jan 11.

Reference Type BACKGROUND
PMID: 21232620 (View on PubMed)

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039-49. doi: 10.1002/art.1780290816.

Reference Type BACKGROUND
PMID: 3741515 (View on PubMed)

KELLGREN JH, LAWRENCE JS. Radiological assessment of rheumatoid arthritis. Ann Rheum Dis. 1957 Dec;16(4):485-93. doi: 10.1136/ard.16.4.485. No abstract available.

Reference Type BACKGROUND
PMID: 13498603 (View on PubMed)

McCarthy EK, Horvat MA, Holtsberg PA, Wisenbaker JM. Repeated chair stands as a measure of lower limb strength in sexagenarian women. J Gerontol A Biol Sci Med Sci. 2004 Nov;59(11):1207-12. doi: 10.1093/gerona/59.11.1207.

Reference Type BACKGROUND
PMID: 15602077 (View on PubMed)

Stratford PW, Kennedy DM, Woodhouse LJ. Performance measures provide assessments of pain and function in people with advanced osteoarthritis of the hip or knee. Phys Ther. 2006 Nov;86(11):1489-96. doi: 10.2522/ptj.20060002.

Reference Type BACKGROUND
PMID: 17079748 (View on PubMed)

de Campos GC, Rezende MU, Pailo AF, Frucchi R, Camargo OP. Adding triamcinolone improves viscosupplementation: a randomized clinical trial. Clin Orthop Relat Res. 2013 Feb;471(2):613-20. doi: 10.1007/s11999-012-2659-y. Epub 2012 Oct 26.

Reference Type BACKGROUND
PMID: 23100188 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

https://www.omicsonline.org/peer-reviewed/parqveproject-arthritis-recovering-quality-of-life-by-means-of-education-shortterm-outcome-in-a-randomized-clinical-trial-20432.html

PARQVE - Project Arthritis Recovering Quality of Life by means of Education. Short-term outcome in a randomized clinical trial

http://file.scirp.org/pdf/OJO_2016022614241788.pdf

. Analysis of anthropometric measures and dietary intake in patients undergoing a multi-professional osteoarthritis education program (PARQVE - Project Arthritis Recovering Quality of Life by means of Education

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042006000400004

Translation and cultural validation of the Lequesne's algofunctional questionnaire for osteoarthritis of knee and hip for portuguese language

Other Identifiers

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15016/16

Identifier Type: -

Identifier Source: org_study_id

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