Phys Ed: What Causes Early Arthritis in Knees?

New York Times
December 9, 2009, 12:01 am
Phys Ed: What Causes Early Arthritis in Knees?
By GRETCHEN REYNOLDS

 Recently, Dr. Constance R. Chu, the Albert Ferguson associate professor of orthopedic surgery at the University of Pittsburgh and director of the Cartilage Restoration Center there, confirmed a theory, and found herself troubled by the results. It turned out that if you dropped a heavy weight onto parts of a cow’s knee joint from various heights, the joint was hurt. (While the parts of the joint were damaged, the cow itself was uninjured by the experiment; the knees came from a local abattoir.) When the weight hit the joint’s surface cartilage with great speed and force, the bone and cartilage fractured. No surprise there. But it is what happened in Dr. Chu’s experiment when the impact was more subtle — closer to, for instance, the perturbations inside a human knee when a ligament is torn — that concerned her. She found that with lighter impact, the various parts of the knee appeared, visually at least, to be fine. But when Dr. Chu and her colleagues examined the cartilage cells just below the placid surface, they found carnage. “Many of the cells within the impact zone” — the area that had been directly thwacked by the weight — “were dead,” she said. They died instantly. More insidiously, other cartilage cells, those outside the injury site, began to die in the hours and days after the impact. “We saw an expanding zone of death,” Dr. Chu said. By the end of her group’s planned observation period, four days after the impact, cartilage cells well away from the original injury site were still dying. The results are fascinating, in a gruesome sort of way. But why should escalating damage to cows’ cartilage matter to the average active human? Well, Dr. Chu says, this study, which was just published in the December issue of The American Journal of Sports Medicine, in conjunction with other researchers’ findings, may help to explain why, she said, “I’m seeing so many patients in their 20s and 30s with knee arthritis after joint injury.” Human knees (as well as bovine ones) are remarkable instruments, able to bear large loads and pivot in multiple directions. But they also damage easily, as evidenced by the approximately 175,000 anterior-cruciate-ligament-reconstruction operations performed in the United States every year, a number that, by all estimates, has risen steeply in the past decade or so. (No agency tracks the procedures.) Many of these operations are being done now on teenagers, who rip an A.C.L. during a soccer or basketball game. (A.C.L. operations were relatively uncommon in young people before youth sports grew so popular.) Others are in men and women in their 20s and 30s who fall on the ski slopes, for instance. What has been less remarked upon is the concomitant growth, Dr. Chu says, in cases of exceptionally early-onset arthritis. Once a disease associated primarily with people past retirement age (and still most prevalent in that age group), osteoarthritis, or degeneration of the cartilage in the knee, has been showing up in much younger people lately. “It’s not only in my practice,” Dr. Chu said. “Most orthopedic surgeons are seeing very young people with very old knees.” An early and mass death of some of their cartilage cells may help to explain why, Dr. Chu says. If the results of her cow study can be extrapolated to human knees, then it’s possible that ripping an A.C.L. doesn’t damage just the A.C.L. The trauma from the incident affects the knee’s cartilage cells, too. These cells make up the tissue that coats the ends of the knee bones. Without this coating, the bones rub against each other. Pain and disability can follow. It’s not yet fully clear, Dr. Chu says, what kills off the cartilage cells located away from the injury site. “The cells could have been injured by the initial impact, not recover and die,” she said. “They could be killed from exposure to noxious substances released by cells that have died. It could also be a combination of the two.” The result is a patch of cartilage in the knee that no longer functions well, if at all. “In a healthy knee, the cartilage is repairing itself all the time,” Dr. Chu said. “But if one loses too many cartilage cells, there can be too few cartilage cells to repair and maintain the cartilage in good condition.” Related More Phys Ed columns Faster, Higher, Stronger Fitness and Nutrition News Unfortunately, the damage to the cartilage cells is invisible, Dr. Chu says. The dead or dying cells don’t show up on a typical M.R.I. scan. “The surface” of the cartilage “looks fine,” she says. The knee, in fact, after the A.C.L. reconstruction surgery, seems to have fully recovered. People return to full activity, including soccer games or skiing, “without realizing that their cartilage is weaker now,” and more prone to re-injury and disintegration, resulting in arthritis. Not everyone who suffers an A.C.L. tear or other serious knee injury develops early arthritis, of course. “Right now, a good guess is that about 50 percent” will have clinical arthritis “within 5 to 10 years” after the injury, Dr. Chu said (meaning, for a 15-year-old, by the time he or she is 20 or 25, and for a 30-year-old, probably before he or she turns 40). “That’s quite a large number.” Dr. Chu and many other researchers across the country are trying to develop methods to determine which people will develop arthritis after a knee injury and why. “Many labs are interested in this question,” she said. But for the moment, no one has had much success. There also are no treatments yet available to slow or stop the deaths of cartilage cells in humans due to an injury. But, Dr. Chu says, one possible response is to “avoid overloading” the injured knee, to coddle the joint, perhaps a little more than might feel necessary. “You may want to alter your activities, even if the knee seems recovered and feels fine,” she said. “Maybe choose bicycling over marathon running,” she said. (For those who recall an earlier Phys Ed column about how running does not appear to harm knees, that finding applied to people who’d never suffered a major knee injury in the past.) The expectation, Dr. Chu says, is that the remaining, weakened cartilage cells will be “protected from a second assault that they might be able to resist when healthy, but are more vulnerable to after injury.” If you are careful with the knee, in other words, you probably lessen your chances of developing arthritis. But that’s not necessarily a message active people want to hear. “I just had a teenage girl in here who’s only three months out” from an A.C.L. reconstruction, Dr. Chu said. “She felt great and wanted to know if she could go ski. It’s hard to tell someone like that that you just don’t know if she’ll ever have a completely healthy knee.”

Phil Jackson is feeling much better- New brace helps with the discomfort that the coach has endured for years.

By Mike Bresnahan
LA Times
November 13, 2009

The smaller things in life ate away at Phil Jackson the last few years.

He felt the toll of 12 seasons as an NBA power forward whenever he stood for too long. Or shifted in his seat at a movie theater. Or simply walked from the locker room to the team bus.

The Lakers’ coach had chronic pain in his back, hips and knees, sometimes skipping games to rest his body.

But Jackson, 64, is feeling better than he has in years.

He is wearing an “unloader” brace on his left knee and seeing the benefits of years of physical therapy.

“I feel really good,” he said Thursday. “I have a device that really takes away a lot of the discomfort that I’ve had. That’s a real big relief for me as far as just having to deal with some issues when I stand or walk. I’m much better that way.

“As far as the edema that I was kind of suffering from flying, obviously, we haven’t been out on the road very much, but that’s well-controlled.”

It brings up a natural question. Because he’s feeling better, is he back next season?

Jackson is in the last year of a contract that pays him $12 million this season, and Byron Scott, who has expressed a desire in the past to coach the Lakers, was fired Wednesday as coach of the New Orleans Hornets.

The Lakers want Jackson back next season, for obvious reasons, and negotiations would be hassle-free, possibly starting as soon as Jackson picks up the phone and calls Lakers owner Jerry Buss.

Jackson typically goes through a health checklist after every season before determining whether to return.

For once, though, health wasn’t the main concern for Jackson when asked about coming back next season. Rather, it might come down to the Lakers’ playoff success . . . or lack thereof.

“It’s all about the season, playing together and how we’re going to do,” Jackson said. “I think that’s the only way you can address it right now.”

Jackson has had both hips replaced and underwent an angioplasty in 2003 to clear a blocked artery in his heart.

The knee brace he is wearing is custom-made, meant to “unload” pressure on the knee by applying more weight on the thigh bone and shifting it away from the knee itself.

Players and team personnel have noticed Jackson’s changed disposition this season.

“When you have a bad back, it’s easy to be grumpy,” forward Lamar Odom said. “I’m not saying that P.J. was grumpy, but most likely, he’s feeling good now.”

Scott scuttled

Scott, 48, was replaced Thursday by New Orleans General Manager Jeff Bower after the Hornets started out 3-6. Scott was in the last year of his contract.

“I think we’re all surprised,” Jackson said. “It’s pretty early in the season. I know that firing’s very hard on owners, but usually the players fire the coach before the owner has to fire him. The players stop responding to the coach. This is a league in which attendance is a key that drives what we’re going to do. Teams have to be able to compete on the floor.”

For more information on this brace, go to http://www.braceshop.com/productcart/pc/Ossur-Unloader-One-Arthritis-Knee-Brace-42p496.htm

Product Review – Cho-Pat Dual Action Knee Band For Patella Tendonitis

Cho-Pat’s newly patented Dual Action Knee Strap provides an extra dimension of relief for painful and weakened knees for all types of sports activities. It is ideal for running, basketball, soccer, tennis and golf. The Dual Action Knee Band is one of the most popular knee bands on the market today, and is useful for a wide range of knee conditions, primarily patella tendonitis, and chondromalacia.

Patellar tendonitis is pain in the band of tissue that connects the kneecap to the shinbone.

Many patients suffer from pain and tenderness around the patellar tendon, swelling where the patellar tendon attaches to the shin bone, pain with jumping, running, or walking, especially downhill or downstairs, pain with bending or straightening the leg.

The most common activity causing patellar tendonitis is too much jumping. Other repeated activities such as running, walking, or bicycling may lead to patellar tendonitis. It is particularly common in people who play basketball. All of these activities put repeated stress on the patellar tendon, causing it to be inflamed.

The Cho-Pat Dual Action Knee Band applies pressure upon the patellar tendon above and below the kneecap to stabilize and tighten up the kneecap mechanism, which improves patellar tracking and elevation and reduces patellar subluxation. The knee band reduces the amount of wear and tear on the undersurface of the joint. It also alleviates the stress to the tendon and promotes healing by redistributing the forces exerted by the quadriceps muscle.

The Dual Action Knee Band’s design and construction apply constant dynamic forces to the surrounding areas of the knee reducing the likelihood of overuse syndromes. At the same time, the strap allows for full mobility while providing maximum benefits.

The strap is ideal for people suffering from the following knee conditions:

1) Jumper’s knee (also known as patellar tendinopathy)

2) Chondromalacia (due to an irritation of the undersurface of the kneecap)

3) Patellar tendonitis (An injury that affects the tendon connecting your kneecap (patella) to your shinbone)

4) Patellofemoral pain syndrome (you feel pain under and around your kneecap, usually caused by the way your kneecap moves in the groove of your thigh bone)

5) Runner’s knee (Patellofemoral Pain Syndrome may be the result of irritation of the soft tissues around the front of the knee)

In conjunction to wearing the support, it is suggested that you reduce the activities that involve the knee tendons and muscles for a few days to help reduce the strain and inflammation. The taking of an oral anti-inflammatory medication may also speed up the healing process if it can be tolerated.

Talk to your doctor about the Cho-Pat Dual Action Knee Band. It is one of the most popular and successful knee bands on the market today. It is always recommended to consult with your treating doctor to determine the correct brace for your orthopedic condition.

Product Review – DonJoy Armor Extreme Knee Brace For Skiing

The DonJoy Armor Extreme Knee Brace is the strongest, off-the-shelf functional knee brace on the market and is designed for active people seeking ligament protection, excellent fit, and superb comfort. Over the years the Armor Extreme has been used extensively during skiing for people suffering from a wide range of knee conditions, primarily ACL and meniscus damage. Many patients utilize the Armor Extreme following knee surgery as a form of protection from re-injury, and allows them to continue to function at the high activity level they were at prior to the injury.

The ACL, or anterior cruciate ligament, is a ligament located inside the knee joint. It is one of the most important of four strong ligaments connecting the bones of the knee joint. The other three ligaments being the Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL).

The function of the ACL is to prevent excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur), as well as limits rotational movements of the knee. Anterior cruciate ligament injuries are more frequent in females with between 2 and 8 times more females suffering a rupture than males. Skiers are more prone to ACL injuries due to twisting (torsional) falls, missteps and binding release issues. Improper condition also is a major cause of ACL and other ligament injuries.

The DonJoy Armor Extreme was designed for the most active of individuals. It offers many features that improve comfort and stability, without sacrificing support.

- A unique 4-Points-of-Leverage cuff and strap configuration, exerting a posterior force against the tibia, preventing anterior movement.

- A strong and lightweight 6061-T6 aircraft aluminum frame for medial / lateral control ensures maximum rigidity.

- Swiveling strap tabs on the frame accommodates changing leg and muscle positions.

- Anti-migration Supra Condyle Pad prevents slippage of the brace.

- Short Calf version to accommodate ski boots.

- Standard Polycentric Hinges for more natural knee range of motion.

- Silver-veined powder coat finish for maximum durability for the serious athlete.

- Optional Patella/Shin impact guards and calf pinch guard.

- Moldable, medial swooping frame for custom fit.

The Armor Extreme comes in a standard length and short calf for ski boot clearance. The brace also comes in a Ski version, which has a medial hinge deflector built into the inside hinge of the brace. This unique feature is for patients that wear two frames braces at the same time. The medial deflector prevents the hinges from catching when the knees are together, thereby preventing potential injury.

The Armor Extreme has been available for many years and has proven to be one of the most functional and supportive braces on the market. Donjoy is one of the largest brace manufacturers in the world and there products have been used by thousands of athletes. If someone requires a maximum supportive brace without customization, the Armor Extreme is one of the best choices in this very competitive market. For more information on this brace including sizing CLICK HERE.

It is always recommended to consult with your treating doctor to determine the correct brace for your orthopedic condition.

For more information on our full line of braces go to www.braceshop.com or call us at (866-325-8045).

Product Review – DonJoy Drytex Economy Hinged Knee Brace For MCL Injuries

The DonJoy Drytex Economy Hinged Knee Brace is a versatile and popular knee support for mild to moderate ligament instability for people with allergies or sensitivities to Neoprene material. Thousands of athletes and non-athletes have used the Economy Hinged Knee Brace for a wide range of sports activities.

The Drytex Economy Hinged Knee is a neoprene alternative, constructed of a unique nylon core and polyester Lycra fabric that allows for improved airflow. This fabric provides compression and support, yet allows for breath ability. It is ideal for patients who have allergies or irritations to neoprene or live in warm weather climates.

The features of the DonJoy Drytex (Sports) Economy Hinged Knee Brace include removable polycentric aluminum hinges, that provides more fluid knee range of motion, compared to lesser quality store bought single hinged type of braces.

The brace offers a choice between a popliteal cutout. (cutout in the back of the brace to allow more breathability and prevent bunching of the material when sitting with the brace. This is a common complaint among many brace owners.

One of the most common questions I receive is whether to get a slip-on or wrap-around, and what is the difference in support between the two styles.

Slip-on style braces tend to provide more even compression than wrap-around styles. Of course the slip-on is easier to put on and take off. The wrap-around style offers more adjustability, especially for larger legs, when the thigh, knee and calf circumferences don’t match the “norm”. The wrap-around style is available in XXXL size for thigh circumferences over 30″ in diameter. Very few companies make a brace this large. Slip-on braces tend to slip more as the brace is worn and stretches out. The wrap-around style by its very nature, can always be adjusted to fit with the right amount of tension, so has a tendency to last longer.

Whichever your choice, both styles provide the same amount of support. It is a question of comfort and fit. For more information on the brace including the full sizing charge and price, CLICK HERE.

For more information on our entire line of braces, go to www.braceshop.com or call us at (866) 325-8045.

Product Review – DonJoy Playmaker Knee Brace

The DonJoy Playmaker Knee Brace is one of the most popular and widely used knee braces on the market. The functionality and price are the main highlights of this versatile and supportive brace. DonJoy is an international brace manufacturer that supplies the US Ski Team, US Snowboarding Team, Canadian Freestyle Ski Team, USA Volleyball team, as well as UCLA, Texas Tech, University of Mississippi and University of Maryland. The DonJoy Playmaker is available in so many styles and sizes, that it used in most every sport for a wide range of orthopedic knee conditions.

Of all the braces on the market today, the most versatile brace is without question the DonJoy Playmaker Knee Brace.

The DonJoy Playmaker is suitable for mild to moderate ACL, MCL and LCL knee instabilities. It has been used by thousands of athletes in all types of sports to help stabilize and support their injured knees.

As an intermediate-level product it has proven over time to be both durable and adaptable to most sports activities, with many added features not usually seen in a fabric hinged style brace.

It is available in neoprene fabric for those athletes in cold weather and water sports. Neoprene helps retain heat and is extremely durable in high impact/contact sports. Skiing, Hockey, Snowboarding, Wakeboarding and Kite Surfing are just some of the sports utilizing the Neoprene Playmaker.

The Playmaker is also available in a material referred to as drytex. This unique nylon core and polyester Lycra fabric allows for improved airflow. The lightweight polyester-nylon weave fabric is ideal for patients who have neoprene-based irritations or allergies, or live in warm weather climates.

The Playmaker also is available in a slip-on or wrap-around style. Wrap-around styles usually are indicated when a persons thigh and calf circumference does not fit the norm, which happens in large athletes, obese individuals, or when a pull on is not practical (removing ski boots or hockey skates). The wrap-around style gives the athlete more adjustability by controlling the tension placed around the thigh and leg separately. The slip-on style is easy to apply and tends to apply more even compression around the knee. The choice is purely a comfort factor and does not affect the support of the brace.

A unique feature of the DonJoy Playmaker is the availability of an open cutout in the back of the knee. One of the most common complaints among athletes and patients is the irritation of the material in the back of the knee. By creating an opening in the back of the brace, bunching of the brace is reduced and the back of the knee is able to breathe. Again, the choice is a comfort factor and does not affect the support of the brace. Many athletes (skiers) prefer a closed back, so as to keep the knee warm.

The greatest features of the DonJoy Playmaker is the basic construction of the brace. Polycentric hinges with contoured condyle shells and the famous 4-point dynamic leverage system provide unsurpassed stability and support for a fabric style brace.

Some of the new features that came out in 2008 is a drop lock style hinge for post op patients and patients that need to lock the brace in full extension when ambulating. The new Fource Point Hinge has been incorporated into the Playmaker. Fource Point Technology was developed to further protect the ACL and enhance the Four Points of Leverage brace design.

The patented Fource Point hinges are designed to react during leg extension and offer an increasing resistance in the last 35 degrees of extension, in order to reduce extension shock and increase posterior tibial loads.

The hinge has three adjustment settings to vary the amount of resistance to meet the specification of the physician’s protocols and the patient’s comfort.

Whichever style Playmaker you decide on, you can be assured that you are getting one of the most popular and supportive braces on the market today. For more information on this brace including sizing information CLICK HERE.

It is always recommended to consult with your treating doctor to determine the correct brace for your orthopedic condition. For more information on other braces please visit us at www.braceshop.com or call us at (866) 325-8045.

Product Review – The Bauerfeind Genutrain Knee Brace

Many athletes & patients ask me what is the most comfortable knee brace on the market? There is no doubt that products by Bauerfeind USA, have historically been the most comfortable and durable elastic braces in the world. As one of the leading medical device manufacturers, Bauerfeind makes an important contribution to maintaining and restoring health, with an unrivaled commitment to quality.

The Bauerfeind Genutrain knee Brace is an anatomically contoured knit support that is breathable and stretched by spiral stays on the sides of the brace. It is a slip on brace with a special knitting technique that make the support extremely comfortable to wear. The brace is only made in Germany.

The high grade elastic knit material is the hallmark of this brace, and is the reason for its popularity among many patients who suffer from arthritis,tendonitis and chondromalacia of the knee.

This is not your typical store brand elastic knee brace.

A circular viscoelastic donut surrounds the knee cap and helps correct the position of the patella to prevent tracking and patella instability. This insert redistributes pressure away from the knee cap to the surrounding soft tissue.

As the knee flexes and extends, the visco donut moves with the knee cap, thereby massaging the surrounding tissue, helping to control swelling and inflammation.

This massage effect is ideal for older patients with arthritis and swelling in the knee, and for people that cannot tolerate the more aggressive arthritic hinged type braces.

Another unique feature that Bauerfeind does with all their knee braces is to lower the compression of the brace around the edges of the thigh and calf areas. This produces a gradual reduction of pressure at both ends of the support and prevents constriction bands from developing in the lower leg. This feature is ideal for patients with diminished circulation.

The brace is low profile and provides exceptional uniform compression. The Genutrain is very popular for golf and tennis as it does not interfere with mobility, flexibility and side to side movement like some hinged type braces.

The Genutrain is available in black, titanium and nature colors. It comes in 7 different sizes and is universal for the left or right leg. The brace is a little pricy due to the US Dollar vs. Euro, but once you put it on, that difference goes away. For more information on the Bauerfeind Genutrain Knee Brace and for sizing information, CLICK HERE.

For more information on our entire brace line, visit us at www.braceshop.com or call us at (866) 325-8045.

It is always recommended that you consult with your treating doctor to determine the correct brace for your orthopedic condition.

Product Review – The Breg Polar Care 500 Cold Therapy Unit Following Surgery

The flagship of BREG’s cold therapy product line, The Polar Care 500 offers a temperature regulated unit for continuous cold therapy. The Breg Polar Care 500 is one of the most utilized and popular cold therapy devices for conditions that require sustained cold therapy to reduce pain, swelling and inflammation. For patients following surgery or injury, it has proven itself to be both reliable and effective.

Why do I need a cold therapy machine?

The two most common side effects of an orthopedic injury or surgery are pain and swelling. These conditions affect the healing process and can lead to longer rehabilitation times. Cold therapy is widely recognized as one of the most effective treatment methods to combat these issues.

Compared to ice and gel packs that provide intense cold over a small area & for a short period of time, requiring frequent trips to the freezer, cold therapy systems, such as the Polar Care 500 can deliver a continuous flow of cold therapy through circulation pads that are specifically designed for different body parts and applications.

The Polar Care 500 can deliver cold within a comfortable temperature range that allows for longer-term application according to your physician’s prescribed treatment protocol.

The Breg Polar Care 500 unit includes a low voltage submersible pump with in-line thermometer and flow valve for temperature control from 35-70 degrees. During use, the pump is submerged in the cooler and connected to a Polar Pad with self sealing couplings. A wall transformer provides power to the pump.

Easy-to-use temperature control gauge that allows for flexibility in adjusting the temperature of the continuous Cold Therapy pad between 35° – 70°. The motor for the Polar Care 500 has an industry-wide track record for reliability. All parts of the Polar Care 500 system can be individually replaced making it more economical to replace a worn out part.

At 11 quarts, the Polar Care 500 has the largest capacity cooler of any single-patient use, continuous Cold Therapy unit on the market and can provide 8 – 11 hours of continuous cold therapy.

Several accessories are available for the Polar Care 500 which enhances its use.

A “Y” adapter can be purchased that allow two extremities to be treated simultaneously. A wide selection of sterile and non-sterile pads are available to fit most every part of your body.

Polar Wraps can be wrapped around each of the Polar Pads, allowing patients to conveniently secure the pads to the affected area without using additional wraps or bandages. The Polar Wraps also control pad condensation.

The Breg Polar Care 500 has a 180 day warranty.

It is highly recommended that you consult with your treating physician before purchasing any cold therapy unit. This unit should only be used under direct supervision of a licensed health care practitioner.  For more information on the Breg Polar Care 500 CLICK HERE.

Cryotherapy should not be used by persons with Diabetes, Raynaud’s or other vasospastic disease, cold hypersensitivity, or compromised local circulation. Please visit our site at www.braceshop.com for more information on this cold therapy unit and other similar units or call us at (866) 325-8045.

The Inside Story on Osteoarthritis

What is osteoarthritis (OA) of the knee?
OA is a painful degenerative condition that develops as the meniscus (cushioning cartilage in the knee joint) and/or the articular cartilage (soft, outer lining of the bones) begin to wear away. OA usually appears on one side of the knee, and affects both men and women across a broad age range.

What causes knee OA?
A variety of conditions can lead to knee OA. A previous knee injury or surgery that partially or entirely removed the meniscus from the knee is a common cause. Simple wear and tear of the knee joint occurring from years of activity can also be a factor.

What causes OA pain?
OA pain results from a deterioration or loss of cartilage. Pain is generally localized on the inside of the knee. Depending on the progression of the disease, the joint space may become small enough to allow the two bones to touch, causing pain.

Do I need knee surgery?
In the early stages of symptoms, a conservative approach is thought to be best. However, based on your history, symptoms, and the amount of degenerative change in your joint, your physician will determine the optimal treatment for you.

What are some non-surgical options?
Off-loading knee bracing is considered one of the best treatment options.  Injections, non-steroidal anti-inflammatory drugs (NSAIDS), supplements, strength and conditioning, including weight loss, and heel wedge insoles may also help reduce OA pain, especially when used in conjunction with bracing.

How effective is OA bracing in treating pain?
Knee bracing is proven highly effective in relieving OA symptoms. Studies suggest that the majority of OA patients using braces report significantly reduced pain, increased activity levels, and a substantial reduction in the use of oral pain medications.

Studies available upon request.

Healthy Knee Healthy knee showing adequate space between bones

OA Knee Osteoarthritic knee showing reduced space and contact between bones.

Why Should I Wear A Knee Brace?

There are basically three types of braces: Post-operative, functional and preventative/prophylactic knee braces. Post-op braces are usually prescribed following surgery or an injury when the knee requires complete immobilization.

There are basically three types of braces: Post-operative, functional and preventative/prophylactic knee braces.

Post-op braces are usually prescribed following surgery or an injury when the knee requires complete immobilization. These braces are usually long braces that may extend from the upper thigh to the lower leg. After surgery or a severe knee injury, mild to moderate pain and edema of the knee occurs. Your doctor may prescribe a knee immobilizer which prevents the knee from bending. These devices are used as an alternative to cast immobilization.

The doctor may also prescribe a post-operative brace that has hinges that offer range of motion capabilities. These post-operative braces are innovative, easy-to-use braces that can adjust the range of motion with the click of a button. These braces can immobilize the knee and then allow controlled increases in range-of-motion as the knee heals and the patient begins physical therapy.

There is no controversy with these types of braces, as they have proven effective and efficient as an alternative to cast immobilization.

Functional braces are hinged supports that support and take over the function of damaged knee ligaments in and around the knee. These braces can be fabric style with hinges, or complete metal frames or carbon fiber. These braces are designed to protect the MCL (Medial Collateral Ligaments), LCL (Lateral Collateral Ligament), Meniscus, ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament). You may have noticed some professional football players using these types of braces.

Prophylactic or preventative braces are supports that are used by some athletes that do not have an injury, but prefer to wear a brace to prevent injury, especially in high impact and contact sports like football, rugby, skiing and water sports. This is where we get some controversy.

Many doctors feel it is not only unnecessary to wear a brace to support a normal joint, but may cause harm, as it may affect the biomechanics of the patients gait. Some doctors are also concerned about weakness in the knee joint from prolonged use of knee braces. The more rigid braces will remove stress away from the knee and the surrounding muscles and ligaments and may cause atrophy and loss of bone density.

Many doctors however feel that given the right circumstances, these braces, when used properly, can provide a level of protection for athletes, especially in high impact sports. Some patients with inherited unstable knees can benefit from this type of brace.

It is important that you consult with your physician and therapist before deciding on a knee brace. There are hundreds of manufacturers and thousands of knee braces to choose from, so it can be very confusing. There are braces specific for ACL tears, and ones for patella tracking. If you purchase the wrong brace for your condition, you may not only risk further injury, but may cause other problems.  Feel free to browse www.braceshop.com and Shop By Condition to see which type of brace you should be looking for or feel free to call our technical department at (866)325-8045.