Patients often report problems with knee immobilizers slipping down or twisting around the leg. Although the device has vertical metal bars for support and Velcro® straps to hold it on, the fit is not always perfect. Individuals who are thin especially have a difficult time getting a good fit.
Sometimes the type of clothing fabric worn under the immobilizer makes a difference. Smooth or slippery material should be avoided. Jean material tends to bunch up and can cause a poor fit. Most teens find that sweatpants work well. The soft material conforms better to the leg giving the immobilizer better contact.
Sometimes with adolescents, it’s more a matter of how it looks than how it feels. They may be self-conscious or don’t want the hassle of putting it on or off. Talk with the surgeon about this situation. Find out the reason he or she wants your son to wear it. If it’s a matter of pain control and your son can go without it, then maybe, it’s not really needed. But if the surgeon is trying to protect the graft site to ensure a successful procedure, then it may help your son to know that.
There are other bracing alternatives. If it’s a matter of a poor fit, then a different size or style might work better. Again, some of this depends on the surgeon’s reasons for recommending bracing. Usually, the soft, unhinged (all one piece) braces limit all knee motion.
A different approach might be to use functional bracing. This type of immobilizer is a hinged brace designed to allow flexion and extension, but not rotation. The brace is made of stiffer material than the unhinged immobilizer and has thin metal bars on either side of the knee to allow motion but prevent rotation.
Call the surgeon’s office and let them know your situation and your questions. It’s likely an acceptable solution can be found with a minimal amount of distress for you and for your son.