A double crossover study was designed and carried out on 39 patients to test the efficacy of valgus bracing using a GII brace in patients with medial gonarthrosis. Two brace designs were studied -- one with a medial and one with a lateral hinge. The double crossover technique involved evaluating each patient under conditions of no brace, brace in neutral, and brace in valgus, each for a period of 6 weeks. Pain and function were recorded by subjects on diary forms daily and at the end of each week. Standing posterior-anterior radiographs were done on all patients under conditions of weight bearing, nonweight bearing, without brace, and with brace in valgus. Statistical analysis using repeated measures analysis of variance showed statisitcally significant pain relief compared to baseline with both a lateral hinge in valgus (p = 0.02) and a medial hinge in valgus (p < 0.0001). No significant change in function was found and no significant radiographic evidence of change in femoral-tibial angle or joint space alteration was demonstrated. Seventy-four percent of patients purchased their brace at the end of the study. Follow-up at an average 20 months after the study showed 58% of the patients with a lateral hinge and 93% of the patients with a medial hinge were still using their braces as the principal form of therapy. Valgus bracing using a GII brace, especially with a medial hinge, can be a useful treatment modality for reducing pain in the patient with medial gonarthrosis to replace or delay surgery.
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