Effects of mechanical interventions in the management of knee osteoarthritis: Protocol for an OA Trial Bank systematic review and individual participant data meta-analysis

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Introduction Knee osteoarthritis (OA) is a prevalent and disabling musculoskeletal condition. Biomechanical factors may play a key role in the aetiology of knee OA, therefore, a broad class of interventions involves the application or wear of devices designed to mechanically support knees with OA. These include gait aids, bracing, taping, orthotics and footwear. The literature regarding efficacy of mechanical interventions has been conflicting or inconclusive, and this may be because certain subgroups with knee OA respond better to mechanical interventions. Our primary aim is to identify subgroups with knee OA who respond favourably to mechanical interventions. Methods and analysis We will conduct a systematic review to identify randomised clinical trials of any mechanical intervention for the treatment of knee OA. We will invite lead authors of eligible studies to share individual participant data (IPD). We will perform an IPD meta-analysis for each type of mechanical intervention to evaluate efficacy, with our main outcome being pain. Where IPD are not available, this will be achieved using aggregate data. We will then evaluate five potential treatment effect modifiers using a two-stage approach. If data permit, we will also evaluate whether biomechanics mediate the effects of mechanical interventions on pain in knee OA. Ethics and dissemination No new data will be collected in this study. We will adhere to institutional, national and international regulations regarding the secure and confidential sharing of IPD, addressing ethics as indicated. We will disseminate findings via international conferences, open-source publication in peer-reviewed journals and summaries posted on websites serving the public and clinicians. PROSPERO registration number CRD42020155466.

Original languageEnglish
Article number043026
JournalBMJ Open
Issue number2
Publication statusPublished - 5 Feb 2021

Bibliographical note

Funding Information:
Competing interests SMAB-Z reports grants from The Netherlands Organisation for Health Research and Development, CZ, European Union, Foreum, Dutch Arthritis Association, personal fees from Osteoarthritis Research Society International (OARSI), personal fees from Infirst Healthcare, and personal fees from Pfizer, all outside of the submitted work. We have no other disclosures.

Funding Information:
Funding EMM was funded by a Canadian Institutes of Health Research (CIHR)

Funding Information:
Banting Postdoctoral Fellowship. The OA Trial Bank has received funding from ReumaNederland (grant number CIO-01).

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Research programs

  • EMC OR-01


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