There are many different types of braces on the market for the knee. Prophylactic braces are used to prevent or decrease the risk of a knee injury. Functional braces stabilize a wobbly knee when the anterior cruciate ligament (ACL) is deficient or after surgery to repair the ligament. Rehabilitative braces limit the amount of knee motion that’s allowed during recovery and rehab after knee surgery. You might be a good candidate for the unloader (sometimes called offloader) brace used to give patients with osteoarthritis of the knee some pain relief.
The off-loader brace just got rated an A for consistent, good-quality patient-oriented evidence based on a review of the literature. All evidence points to the use of off-loader braces as a good way to improve knee stability while reducing knee pain. The brace is meant to be used by patients like yourself who have unicompartmental knee osteoarthritis. Unicompartmental arthritis affects one side of the joint (usually the medial side — the side closest to the other knee).
Unicompartmental knee osteoarthritis is a common problem associated with alignment problems, obesity, and aging. Some people have a slightly inward angle at the knee that results in more weight being placed on one side of the knee. It could be a valgus angle, which is more toward a knock-kneed position that leads to lateral unicompartmental osteoarthritis. Or (more commonly), it could be a varus angle, a bow-legged position resulting in medial unicompartmental osteoarthritis. Either of these two malalignment problems causes cartilage degeneration and ligament laxity, bringing the joint surfaces closer together. The result is an increased load on one side of the joint.
The unloader or off-loader brace uses adjustable straps and pads to apply an external force to distract the involved compartment. It’s a mechanical intervention meant to reduce pain, which in turn, increases function. The long-term goal is to keep the arthritis from getting worse. By improving the alignment of the knee, compressive force and load are shifted off the already damaged area of the joint.
You may be a good candidate for this brace. X-ray evidence of unicompartmental knee osteoarthritis is required. Patients who have failed to get benefit from standard medical care are also recommended for this type of bracing. Standard first-line medical treatment includes nonsteroidal antiinflammatories, steroid injections, and viscoelastic supplementation.
If you have already gone through at least six-months of conservative (nonoperative) care with little to no improvement (or even worsening of symptoms), ask your doctor about this type of brace. If you have not tried some (or all) of the standard measures of care, talk to your doctor about best options for you given your history, clinical presentation, and personal goals.