More Resources

Bannuru et al. (2019)

OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteo. Cartl. 27(11).

Binkley et al. (1999)

The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys. Ther. 79(4).

Cherian et al. (2015)

Strength and functional improvement using pneumatic brace with extension assist for end-stage knee osteoarthritis: a prospective, randomized trial. J. Arthroplasty. 30(5).

Duncan et al. (2006)

Prevalence of radiographic osteoarthritis – it all depends on your point of view. Rheum. 45(6)

Hart et al. (2017)

The prevalence of radiographic and MRI-defined patellofemoral osteoarthritis and structural pathology: a systematic review and meta-analysis. B. J. Sports Med. 51(16).

Heekin & Fokin (2014)

Incidence of bicompartmental osteoarthritis in patients undergoing total and unicompartmental knee arthroplasty: is the time ripe for a less radical treatment?. J. Knee Surg. 27(1).

McAlindon et al. (2014)

OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteo. Cartl. 22(3).

Messier et al. (2018)

Intentional weight loss in overweight and obese patients with knee osteoarthritis: is more better? Arthritis Care Res. (Hobokin) 70(11).

Military Case Study

Levitation TCU Knee Brace Case Study: 18-year-old male with patellar dislocation, fracture, and osteochondral lesion.

Tubach et al. (2005)

Evaluation of clinically relevant states in patient reported outcomes in knee and hip osteoarthritis: the patient acceptable symptom state. Ann. Rheum. Dis. 64(1).

Zhang et al. (2008)

OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteo. Cartl. 16.

Research Summary

Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition

Jevsevar, D.S. (2013) J. Am. Acad. Orthop. Surg. 21(9): 571-6. doi: 10.5435/JAAOS-21-09-571.

Key Findings

A systematic literature review was conducted for the purpose of replacing the 2008 AAOS clinical practice guidelines, which had used evidence with methodologic issues. The updated guidelines include 15 recommendations and highlight the need for better research on the treatment of knee osteoarthritis (OA).

For patients with symptomatic OA, the updated guidelines recommended self-management programs, strengthening, and low-impact aerobic exercise as treatments. For patients with symptomatic OA and a body mass index above 25, weight loss was also a recommended treatment.

The guidelines were unable to recommend valgus bracing for patients with symptomatic knee OA due to inadequate evidence supporting its efficacy. However, recommendations state that practitioners should not avoid prescribing valgus braces solely based on the poor research quality.

Relevance to Levitation

Although the guidelines were unable to recommend valgus bracing due to poor research support at the time of the study, Levitation is unlike many OA knee braces due to its unique, evidence-supported design. As a tri-compartment unloader with a powerful knee extension assist, Levitation is capable of providing pain relief and functional improvements to a broad range of OA patients, including those with multicompartmental or patellofemoral knee OA 1– Bishop, E.L. et al. (2020) Osteo. Cart. Under Peer Review. 28: S243-S244
– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review.
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Of further therapeutic importance, Levitation has been shown to reduce joint loads by an amount equivalent to 45 lb of weight loss 2– Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1). For many overweight or obese knee OA patients, a reduction of 45 lb is in line with the amount of weight loss associated with clinically meaningful improvements 3– Messier, S.P. et al. (2018) Arthritis Care Res. (Hobokin) 70(11): 1569–1575. As such, Levitation may provide patients with outcomes similar to weight loss or help them achieve additional weight loss or lead a more active lifestyle through improvements to their levels of knee pain, function, and physical activity levels 4– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review..

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