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In the long term it is important to protect the joint cartilage from further destruction to postpone surgery as long as possible. Patients with unicompartmental knee OA (i.e. varus or valgus knees) may benefit from unloading braces. These braces take off the pressure from the areas where the OA is worst by applying corrective forces. They also offer improved proprioception and knee stability. In the past, knee braces used to be big and bulky and uncomfortable to wear but in the recent years new models with proven efficiency have been developed.
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.
Step 3: Try it
When you go shopping for a new pair of jeans you invariably need to try them on to check their fit, how they feel and how they look. It’s the same when considering knee braces as they are all different, with varying materials and fits.
This is why we would recommend working with a clinical professional to have a brace fitted so that you can be fitted professionally and have the chance to try it in a controlled environment before heading out into the big wide world.
Another important note is that bracing is just one treatment pathway and good practice suggests not using any one pathway in isolation, but combining them for the most effective approach to managing the condition i.e. working on your nutrition combined with an increase in activity levels whilst wearing a brace to help facilitate your movement.
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.
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