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Most commonly occurring in the knee, osteoarthritis is a degenerative condition that is most common in the 50-plus age group, although younger people may also be affected. Osteoarthritis is the gradual wearing away of the knee cartilage, usually due to everyday wear and tear. As the cartilage becomes more worn, the surface changes and the protection between the bones lessens. In severe cases, this can result in bones rubbing together. There is also the potential for bone spurs to develop, which can be particularly painful.
Symptoms of knee osteoarthritis
In most cases, knee osteoarthritis symptoms develop gradually. Symptoms can manifest suddenly, but this is quite rare. Common symptoms include:
- Stiffness and swelling in the joint, which can make it difficult and painful to bend the knee or straighten it
- Increased pain or swelling first thing in the morning or after a period of inactivity
- Increased pain after a period of vigorous activity
- The knee sticking or appearing to lock momentarily
- The joint making clicking, snapping or grinding noises
Treatment for knee osteoarthritis
In very severe cases, surgery may be recommended; however, it is usual to pursue nonsurgical treatment in the first instance. This can be highly effective in reducing or even eliminating most symptoms.
Lifestyle modifications, such as losing weight, stopping or reducing activities known to cause symptoms and changing exercise regimes from high-impact to low-impact options, will generally produce positive effects; however, it is important to acknowledge that knee osteoarthritis is a degenerative condition. There is no cure, although the condition may not get any worse. The focus when looking for treatment is therefore on preventing the condition from getting worse as much as possible and limiting pain and stiffness.
Using assistive devices can go a long way towards helping to manage knee osteoarthritis. These include using a cane, wearing shoes that are both supportive and have shock-absorbing qualities, and wearing a knee support brace.
The best knee brace for osteoarthritis will depend on the individual and the symptoms, with several options available.
How do you find the right brace?
A quick look on Google using the term 'knee brace' or 'knee support' and you’ll see pages of results. Use the same search in Amazon and you’ll be faced with thousands of products to select from.
So the big question is “how do you find the right one?”
To make this process simple we’ve put together a quick 3 step process for determining the right brace.
Step 1: Diagnosis
Each brace is different this is important to understand from the outset.
Some are designed to offer compression, which helps to manage inflammation and offer pain relief, but would offer little to those suffering from a degenerative condition such as osteoarthritis or where there is instability following ligament damage and therefore not help.
Likewise a brace designed to offer stability to help maintain mobility following ligament damage is designed for just that and would offer little to osteoarthritis sufferers.
Even when considering osteoarthritis you need to understand the root cause of the problem. Is one side of the knee affected (unicompartmental)? Both sides? or the patella (knee cap), which is referred to as patellofemoral osteoarthritis?
This is why an accurate diagnosis is essential so that you are then able to find a brace which is specially designed for managing your condition.
Step 2: Research & Verify
Most websites have filter options on their products so that you can start to drill down to the ones which are suitable. Ensure that you single out the braces which are designed to manage osteoarthritis.
Once you’ve done this, and your list can still be somewhat extensive, check that these products are designed to manage the severity of the condition you are experiencing.
If you are ever unsure then speak with the manufacturer or website operator before making a purchase. You could also ask for advice from a clinical professional who may be able to recommend something specific for your needs.
An effective knee support brace will need to combine several qualities, including:
- Weight: Anything that will be worn regularly must be lightweight; otherwise, it will cause fatigue and possible pain.
- Bulk: Whilst an osteoarthritis brace is unlikely to be the most attractive part of your attire; however, the less bulky it is, the more likely it is to be able to be worn in a way that draws little to no attention, particularly if worn under trousers. The bulk of the brace is also important when considering the potential to rub against the other leg and your comfort when sitting and standing.
- Strength: To provide good support and the potential for significant pain relief, it is important that the brace can stand up to prolonged wear over time. Lesser-quality materials may distort or stretch over time. A good-quality brace is also more likely to be able to withstand all activity levels.
- Adaptability: A good-quality off-the-shelf brace is likely to be available in more sizes and be more adaptable to different individuals. Bespoke options are also available; of course, these are likely to be more expensive.
Step 3: Try it
Incredibly, many people will opt to order a knee support brace from a supplier on the internet without any individual fitting advice or the opportunity to try on a brace to determine its suitability, benefits and comfort. Individuals will often put more thought and effort into buying a new pair of shoes or jeans than into buying a knee brace, which has the potential to dramatically alter their daily life.
The difference between a knee brace that fits well and provides the support it is meant to and one that does not can be quite dramatic. It is always advisable to work with a clinical professional to ensure that a brace is fitted properly. A professional will understand how to fit a brace so that it is comfortable whilst standing, sitting, walking, and moving in general. They will be able to talk to you about what to expect and how to get the most out of a brace.
Working with a professional will also give you the benefit of being able to try the brace in a controlled environment. This enables you to understand how the brace works and get used to it before trying to use it on uneven surfaces, such as pavements.
A clinical professional will also be able to appreciate how other pathways will work effectively in combination with a brace. It is rare that the usage of a brace is the only approach used, with pain relief, nutrition and targeted exercise also likely to be part of the overall management of the condition.
Ultimately, with the correct clinical advice and help, an individual should be able to experience a significant improvement in mobility, stiffness and pain through the use of a brace. This can also mean that surgery either becomes unnecessary or is significantly delayed.
Unloader bracing is used for uni-compartmental osteoarthritis of the knee, where there is degradation of cartilage in one side of the joint.
The focus on unloading is to shift the force away from the affected side of the knee to the less affected side, thereby reducing the bone on bone contact when mobile and taking away the pain for the patient.
The Unloader One from Össur is designed for use in mild to moderate cases of osteoarthritis and offers unloading leverage through a Dual Dynamic Force Strap system. The Dynamic Force Control System also allows sufferers to adjust the level of tension on the brace manually when on the move, since the pain experienced may be worse at certain times of the day, during certain activities or even vary depending on the weather.
The product is not available to buy online but is instead a professionally fitted product, with a clinical professional ensuring first off that you are suitable for the brace prior to fitting it and offering peace of mind.
For information on the brace and what it can offer visit www.ossur.co.uk
The Unloader Moment
A number of clinical studies have been undertaken regarding the Unloader One (listed below), however the Unloader Moment stands out. The purpose of the study was to capture on film the moment a person suffering from osteoarthritis wore the brace for the first time and was pain free.
The study was undertaken by Dr Sheila Strover from Knee Guru.
You can view the entire study here.
Patellofemoral Osteoarthritis Bracing
The patella (or knee cap) is also susceptible to osteoarthritis, causing pain in the front of the knee and making it difficult for sufferers to kneel or even climb stairs. The root cause of the issue is where the underside of the articular cartilage in the trochlear groove (where the patella sits) begins to wear down and becomes inflamed.
The wear and tear is severe the bone can become exposed to the rough surface of the trochlear groove and is the main source of the pain.
You may find the following products useful, both of which are designed to manage the symptoms associated with osteoarthritis of the knee:
- Unloader One from Össur
- Karen K. Briggs, Lauren M. Matheny, J. Richard Steadman: Improvement in Quality of Life with Use of an Unloader Knee Brace in Active Patients with OA: A Prospective Cohort Study
- Pollo FE, Otis JC, Backus SI, Warren RF, Wickiewicz TL: Reduction of medial compartment loads with valgus bracing of the osteoarthritic knee.
Additional references to scientific publications in peer-reviewed journals on osteoarthritis of the knee, bracing and the effectiveness of the Unloader One are available here.