caa a22 4500 605457123 CHVBK 20210128100221.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-013-2832-1 doi (NATIONALLICENCE)springer-10.1007/s00167-013-2832-1 Valgus bracing in symptomatic varus malalignment for testing the expectable "unloading effect” following valgus high tibial osteotomy [Elektronische Daten] [Philipp Minzlaff, Tim Saier, Peter Brucker, Bernhard Haller, Andreas Imhoff, Stefan Hinterwimmer] Purpose: The purpose of this study was to evaluate whether the expectable postoperative pain relief following valgus high tibial osteotomy (HTO) is reliably predictable with the temporary use of an unloading knee brace preoperatively. Methods: Fifty-seven patients with symptomatic varus malalignment were treated with a valgus producing unloading knee brace for 6-8weeks. The pain intensity in the respective knee compartment was monitored using the visual analogue scale (VAS) before and following this treatment. A "positive” Brace-Test was defined as a pain relief medially without initiated symptoms laterally. In these cases, a valgus HTO was suggested as a promising surgical option. Patients who were subsequently operated were clinically re-evaluated 1year postoperatively to compare the postoperative outcome with the result of the Brace-Test. Results: The mean VAS score decreased from 6.7 [standard deviation (SD) 1.6] to 2.5 points (SD 1.7) (p<0.001) following the Brace-Test. Overall, 48 patients had a positive test. A valgus HTO was performed in 29 of them. The mean postoperative VAS score was 1.9 (SD 1.7) points with no difference to the result of the test (n.s.). Nineteen patients with a positive test initially decided for a conservative treatment. In three of nine patients with a negative test, a total knee replacement was performed. Conclusion: This study shows that the temporary use of an unloading valgus producing knee brace may well predict future outcome of HTO surgery in terms of expectable postoperative pain relief. The Brace-Test gives both the patient and the orthopaedic surgeon more detailed preoperative information, especially in critical or borderline indications. Thus, it is a useful tool to test the unloading effect before indicating an HTO. Level of evidence: III. Springer-Verlag Berlin Heidelberg, 2014 High tibial osteotomy nationallicence Malalignment nationallicence Osteoarthritis nationallicence Unloading brace nationallicence Brace-Test nationallicence Minzlaff Philipp Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut Saier Tim Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut Brucker Peter Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut Haller Bernhard Institute of Medical Statistics and Epidemiology, Technische Universitaet Muechnen, Munich, Germany aut Imhoff Andreas Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut Hinterwimmer Stefan Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1964-1970 0942-2056 23:7<1964 2015 23 167 https://doi.org/10.1007/s00167-013-2832-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2832-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Minzlaff Philipp Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Saier Tim Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Brucker Peter Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Haller Bernhard Institute of Medical Statistics and Epidemiology, Technische Universitaet Muechnen, Munich, Germany aut NATIONALLICENCE 700 1- Imhoff Andreas Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 700 1- Hinterwimmer Stefan Department for Orthopaedic Sportsmedicine, Technische Universitaet Muenchen, Munich, Germany aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1964-1970 0942-2056 23:7<1964 2015 23 167