Valgus Directing Force Brace
We are unable to recommend for or against the use of a valgus directing force brace (medial compartment unloader) for patients with symptomatic osteoarthritis of the knee.

Rationale
This recommendation is based on three separate studies; one high-strength study78 compared a valgus producing brace plus usual care to a neoprene sleeve brace plus usual care and to usual care alone.  A second high-strength study compared a valgus directing force brace to a lateral wedge foot orthotic.79 The third study of moderate-strength compared a valgus directing force brace plus usual care to usual care alone.80 Therapies were compared with respect to how much they improved pain, stiffness, self-reported functional capacity, and physical performance measures (observed walking distance and number of stairs climbed in 30 seconds). Improvement using the varus producing brace was not consistently significant across the four studies. For all statistically significant comparisons, the clinical significance of the improvements in pain and physical function were unclear.
 
Based on a lack of appropriate studies, the use of a varus directing force brace was not evaluated.

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