変形性膝関節症に対する装具療法－軟性膝装具と足関節吊下げ型足底板との併用効果－

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  • An Orthotic Device for Patients with Osteoarthritis of the Knee—The Efficacy of a Soft Orthotic Device for the Knee with Subtalar Strapped Insole—
  • ヘンケイセイ シツカンセツショウ ニ タイスル ソウグ リョウホウ ナンセイ シツ ソウグ ト ソクカンセツ ツリサゲ ガタ ソクテイバン ト ノ ヘイヨウ コウカ

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Objective: The lateral wedged insole with a subtalar strapping (hestrapped insole) for patients with medial compartment osteoarthritis (OA) of the knee has the disadvantage of permitting knee buckling in patients with anterior-posterior laxity. To resolve this problem, we modified treatment with the strapped insole by combining it with an elastic knee orthotic device and we assessed its efficacy.<br>Method: Fifty eight patients with OA of the knee were prospectively randomized into a group treated for four weeks with a heat-retaining knee sleeve (heat-retaining sleeve, n-20), a group treated for four weeks with a relatively long elastic mechanical knee sleeve with hinged struts (functional sleeve with struts, n-19), and a group treated for four weeks with a short sleeve without hinged struts (functional sleeve without struts, n-19). All patients were instructed to use the strapped insole as adjunctive therapy. Patients were permitted to stop using the orthotic device at any tim e during the course of the 4 week study if any discomfort developed that they had not experienced before using it.<br>Results: A higher propotion of patients stopped using the functional sleeve with struts (13/19, 68.4%) than stopped using the heat-retaining sleeve (2/20,10%) or the functional sleeve without struts (4/19, 21.1%).<br>Conclusion: The functional sleeve without struts may be more comfortable and effective than the heat-retaining sleeve and functional sleeve with struts for constant routine use with the strapped insole.

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