Unloading Knee Brace

Unloading Knee Braces were developed to treat certain types of osteoarthritis. The traditional treatment plan for knee osteoarthritis was to use painkillers until they didn't work anymore, followed by joint replacement surgery.

The modern treatment plan looks at every stage of the disease process, trying to prevent or delay the need for major orthopedic surgery. This involves some of the less popular but most effective treatments such as weight loss and quadriceps strengthening exercises. Unloading knee braces are also becoming an important part of the long term management of knee arthritis.

Surgeons are often reluctant to perform joint replacement surgery on young people. This is because their much higher levels of activity shorten the working life of the replacement resulting in complicated revision surgery often in less than 10 years. Joint replacement is best left until you are 60 or older. Unloading knee braces can help you remain active while buying you some time. If you are going to have a joint replacement for your knee osteoarthritis, it is best to have the first one last you for life.

 An unloading knee brace does not help every type of arthritis. It is only for Osteoarthritis, not Rheumatoid Arthritis.

For those with osteoarthritis, the location of the arthritis is important. These braces only help those with the majority of their arthritis in half of their knee. Either the inside half (medial side) or the outside half (lateral side). Doctors call this Unicompartmental arthritis. If you have arthritis in both the inside and outside of your knee you should not use this type of brace.

Unicompartmental arthritis is associated with changes in the angle at the knee. When the inside half is worn the result is becoming "bow-legged". When the outside is worn the legs become known as "knock-kneed". If you are bow-legged or knock-kneed, an unloading brace may be suitable for you.

 Once half of the knee becomes worn, the change in angle at the knee means it begins to take more body weight. This in turn makes the arthritis progress faster. Unloading knee braces apply a sideways force to the knee that decreases the load taken by the worn half of the knee.

There are different types of brace, some with hinges on either side of the knee, some with a single hinge. The mechanisms differ but the end goal is the same. To decrease the weight you take through the worn part of your knee in every step you take.

The latest generation of braces are proving the most effective but have not had much time to build a strong evidence base. A study in the Journal of Bone and Joint Surgery looked at 5 different unloading braces. They concluded that:

"OA bracing is an effective mode of treating unicompartmental degeneration; articular separation of a degenerated knee compartment can be achieved consistently with 2 braces : Bledsoe Thruster 2 and DJO OAdjuster."

In other words, these two braces did what they claimed to do - decrease the load to the worn half of the knee.

Another recent study looked at 49 people and found that those using the Ossur Unloader One took significantly less painkillers than a control group.

If you are looking for an unloader knee brace, the suggested starting points would be those with the research backing them: The OAdjuster by Donjoy, the Thruster 2 by Bledsoe, and the Unloader One by Ossur.

Offloading braces are technical pieces of equipment. You should consider finding a local Physical Therapist who is familiar with a particular brace to order, fit, and instruct you in its use. Unfortunately this is more expensive than ordering the brace yourself.

You can purchase these braces from online retailers such as Amazon (see right) but for around the same price you can also buy them from specialist bracing retailers with knowledgeable customer service teams that can help you choose the most appropriate brace. A good example of this is The Brace Shop.