Artikel
Efficacy of the dorsal knee extension orthosis after gonarthritis: A retrospective analysis
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Autoren
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Faekah Gohar
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Daniel Windschall
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst; Martin-Luther-University Halle-Wittenberg, Medical Faculty, Halle (Saale)
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Anja Blöthe
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Antje Bannick
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Christine Fischer
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Helen Grulke
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Verena Matthey
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Lea Zülch
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
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Katrin Wichmann
- St. Josef-Stift Sendenhorst, Paediatric Rheumatology, Sendenhorst
| Veröffentlicht: | 18. September 2024 |
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Gliederung
Text
Introduction: Acute and chronic knee arthritis in juvenile idiopathic arthritis (JIA) can result in joint contractures due to muscle and ligament shortening. Use of the overnight dorsal knee extension orthosis (KO) can help reverse extension deficits (ED). However, few studies quantify their efficacy in JIA.
Methods: JIA patients treated with a KO after intra-articular cortisone application (IACA) for gonarthritis between 03/2015 – 03/2023 were included. Exclusion criteria were: no follow-up (FU) after KO initiation, no documented end date with ED and/or co-existing valgus deformity. Disease characteristics and passive ED (examined by specialised physiotherapists) were analysed.
Results: 20 patients (75% female) aged median 2.4 (range 1–5) years at JIA diagnosis with 23 affected knees were analysed. Oligoarthritis persistent (n=12), Oligo-extended arthritis (n=1) and seronegative Polyarthritis (n=7) was diagnosed at median 4 (range 0–25) months prior to KO start. All patients were DMARD/BMARD naïve. At KO start, 5/23 knees had had a previous gonarthritis episode with IACA. The ED at KO start was: maximal 0° (6/23 knees), 0–5° (4/23), 6–10° (5/23), 11–20° (4/23) and >20° (4/23). Change in ED at FU is shown (Table 1 [Tab. 1]). The duration of KO treatment was a median 6 (3–17) months and in 11/23 knees KO could be ended at FU-1. At treatment end, 17/23 (74%) knees had an overextension of >5°, and 6/23 (24%) reached 0–4°. No knees had persistent extension deficits or worsened flexion.
Conclusion: All knees were without ED by treatment end without complications in this small study, supporting the use of KO for the treatment of knee ED after IACA in patients with JIA. Many also achieved overextension, which requires manual training (by physiotherapists/family) in parallel to the KO. A prospective study to further examine the effectiveness and also the acceptance of the KO is planned.
Disclosures: FG has received a grant from the GKJR for a prospective study into the effectiveness and acceptance of dorsal knee extension orthoses.
