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Case Study: Custom V-VAS™ Knee Orthosis Offers Non-surgical Treatment for Osteoarthritis

Posted by Anatomical Concepts on Jan 26, 2021 4:57:31 PM

 

Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis and affects millions worldwide. It happens when the cartilage in the joints – most commonly the hip, spine or knee - breaks down. Symptoms of osteoarthritis include pain or tenderness, popping or cracking, stiffness, loss of flexibility and swelling. 

So when the pain gets to be too much for the patient, and symptoms become unbearablesurgery becomes an option. But not always the best one. Sure, it might fix the problem and stop the pain, but surgery may not be necessary, especially for younger patients, those with health risksor patients in palliative care. If only there were another treatment option you could recommend to your patients that would be less invasive but effective. 

There is. It’s called the Custom V-VAS™ Knee Orthosis. 

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This one-of-a-kind offloading/realigning brace is designed to help patients manage osteoarthritis symptoms as an alternative to surgery. Combined with staying active, maintaining a healthy weight and therapy treatments, the orthosis can help slow the progression of the disease and help improve pain and joint function. This device is designed to re-align the leg back into the proper position and lessen the pressure being placed on the worn-down area of the knee joint.  

That means immediate pain relief when being active and less wear and tear on the joint. The offloading brace is an ideal lightweight non-invasive solution that reduces pain, retrains the leg to move correctly, and gets patients back to everyday life – without surgery. 

Key Benefits of the Custom V-VAS™ Orthosis include: 

  • Allows the patient to reap the benefits of improved physical activity  
  • Complements physical therapy by reducing pain during weight-bearing activities  
  • Alternative to surgical intervention 
  • Reduces the need for pain and anti-inflammatory medications  
  • Fully adjustable while on the patient's extremity  
  • Complements Hyaluronic and steroid injections by diminishing compressive forces  
  • A new alternative to traditional designs for optimal patient outcomes 

Innovative Design and How it Works 

This knee orthosis provides a new concept in treating patients who present with medial or lateral compartmental arthropathies. Its custom design incorporates several unique features that increase the effectiveness and compliance of the patient in need of an unloader orthosis.  

The Custom V-VAS™ Knee Orthosis helps achieve optimal varum or valgum stress, without bulky or complex adjustments. Its unique polycentric adjustable hinge design creates an ideal bending movement that results in the precise offloading/realigning experience of the knee. It's the first long axis offloading, closed dynamic frame custom knee orthosis that doesn't need to be removed to adjust weight offloading and the mechanical axis is always non-binding and auto aligning. 

Instead of using a narrow frame as seen on most double and single upright designs, it uses a total contact cuff on the thigh and tibia along with a unique adjustable self-aligning polycentric joint system to create four points of pressure instead of three.  

With two points of pressure applied as a counterforce (located at the proximal and distal ends of the thigh and tibial cuffs on the affected side of the leg) and two points of pressure applied as the corrective force (located at the distal and proximal ends of the thigh and tibial cuffs respectively on the non-affected side of the leg) to offload the affected compartment, there is no need for a condylar pad.  

As compared to the single upright design, the use of a counterforce strap is not necessary due to the four points of pressure used to create the bending offloading moment. This unique advantage is reproducible with each application and eliminates the subjectivity of a counterforce strap or condylar pad that are present in other designs.  

Its self-aligning polycentric hinge design features an effective means of linearly adjusting the varum or valgum angle (depending on which compartment is affected) without causing mechanical joint binding. This is a very patient and practitioner friendly design due to the mechanical joint allowing for non-mechanical like bending of the knee and never needing re-squared.  

Potential Applications for Patient Use  

The V-VAS™ Knee Orthosis has been found very effective for: 

  • Clinical management of patients with symptomatic medial compartment osteoarthritis 
  • Lateral compartment osteoarthritis 
  • Abnormal genu valgum alignment with up to 30° of semi-flexible deformity non-operative tibial plateau fractures 
  • Failed hardware or reconstruction of the tibial plateau 
  • Tibial plateau and or femoral condyle spacers  
  • Post total knee arthroplasty 

Case studies have shown that the offloading forces exerted by these devices are successful in relieving pain in those patients with uni-compartmental osteoarthritis during weight-bearing activities. Here is a summary of how the device helped two groups of patients experiencing painful symptoms of osteoarthritis 

Case Study Overview & Key Results  

The following study reports the results of using a custom-made knee orthosis, the V-VAS, as an alternative to surgical intervention for osteoarthritis 

Various orthosis designs exist for the management of patients with osteoarthritis of the knee. Custom or off-the-shelf unloader knee orthoses are widely used for relieving pain during weight-bearing activities in patients with uni-compartmental osteoarthritis. Although these designs can be mechanically successful, patient tolerance may be low due to a higher concentration of pressure exerted by straps or condylar pads. This is especially present with severe deformity and can limit how an orthosis can be tolerated. 

The authors of this study applied the custom orthosis design (V-VAS) in an experience of more than 100 fittings. This concept was chosen because of its ability to fine-tune comfort levels at the time of fitting and its' lightweight and efficient biomechanical design. 

Patient Profiles 

The two main patient groups selected for the case study presented with valgus/varus deformity of the knee in excess of 10 degrees and medically unfit for surgery (GROUP 1) or those too young to be considered for knee replacement surgery (GROUP 2). In Group 2, bracing was seen as an earlier option than osteotomy and could be used in conjunction with pain-relieving injection therapy. 

Patients liked the fact that the design closely followed the profile of the knee without binding. Each patient was assessed radiographically and a custom cast made of the knee. Partial correction of the deformity by the orthotist during cast taking was crucial in minimizing patient discomfort.  

The patient’s perception of pain was used as an indicator of the optimal position during cast taking. It is likely that by demonstrating that pain relief could be achieved during casting, the patient’s expectations of the brace were raised. 

Patient Results 

Group 1: All patients were asked after six weeks to willingly return the device and all refused. All patients reported a reduction in their pain by 50-70%, and more than 50% reported an increase in mobility in terms of their day to day tasks. In all cases, the patients said that the quality of life outcomes exceeded their expectations. 

Group 2: One patient found the brace difficult to use due to a hypersensitivity following trauma and derived little or no benefit. One patient had an initial benefit, reporting 50% pain reduction, however, they elected for surgery as a final treatment option. The remainder reported a reduction in pain by 50-70%. They were not willing to go without their brace. Mobility was improved, with around 10% returning to everyday physical activity. 

To learn more about how the V-VAS™ Knee Orthosis and request a quote today, click the button below.

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Tags: Orthotic Treatment, Pain Management, Patient Care