Anterior Knee Unloader Brace Prescription Yields Moderate Compliance Rates and Improved Clinical Function in Patients with Patellofemoral Pain

Purpose To determine clinical outcome changes and wear compliance rates associated with the use of a custom‐fit anterior knee unloader brace in a prospective cohort of patients with clinical symptoms derived from patellofemoral osteoarthritis (PFOA). Methods Adults ≥ 18 years with PFOA or multicompartment OA with patellofemoral involvement were enrolled in this study. Participants received a custom‐fit Icarus Ascender OA Brace with instructions to wear it during daily activity for 4 weeks. Patient‐reported outcomes (PROs) were collected at the pre‐ and postbracing intervals. PROs were compared from pre‐ to postbracing time points. Improvement from moderate or severe symptoms prebracing to mild or no symptoms postbracing was analyzed. Results One hundred thirteen patients (134 knees) completed pre‐ and postbrace surveys (age: 53.5 ± 13.1 years, 43.4% female, 48.7% left knee). Sixty‐two (56.9%) patients reported wearing the brace ≥ 4 times a week, with 37 (33.9%) reporting daily use. Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS JR) improved 21.62 ± 14.47 points ( P < .001), with improvements of 0.88 ± 1.09 points ( P < .001) in stiffness, 4.91 ± 3.17 points ( P < .001) in pain, and 2.46 ± 1.82 points ( P < .001) in Activities of Daily Living (ADL) subscores. Visual Analog Scale (VAS) pain scores improved 4.04 ± 2.10 points (59.3 ± 23.2%, P < .001). 66.42% of knees exceeded minimum clinically important difference (MCID) for KOOS JR. MCID achievement was higher in patients reporting “moderate or worse” stiffness (75.24%), pain (77.66%), and functional limitation (78.72%) baseline KOOS JR subscores compared with those reporting “mild or no” stiffness (39.39%), pain (40.00%), and functional limitation (37.50%). Sixty‐two of 71 (87.32%) patients reported “moderate or worse” symptoms for stiffness, pain, and ADL subscores. Conclusions Prescription of an anterior knee unloader brace in patients with PFOA or multicompartmental knee OA with patellofemoral involvement results in moderate compliance and improvement in pain and clinical function in the majority of patients at short‐term follow‐up. Level of Evidence Level IV, therapeutic retrospective case series.