According to USA Today, the number of knee replacement surgeries has grown substantially over the last 20 years, costing our government over 5 billion dollars. That amount will continue to grow as the baby boom generation continues to age.New technologies are being utilized to reduce the need for knee replacements.
Stem cell treatments, partial knee replacement, arthrosurfacing and HemiCap Implants are just some of the new treatments being utilizing as an alternative to the joint destructive procedure known as the total knee.
Another existing conservative treatment is the utilization of the arthritis or “unloader” knee brace. These rigid framed braces have been used for over a decade, and are designed to reduce the “bone on bone” contact between the femur and tibia. These arthritis braces are limited given the fact that they can only be used uni-compartmentally. If both compartments of the knee (medial and lateral) demonstrate severe arthritis, with lack of cartilage and joint fluid, the unloader type of braces are not effective. In instances of patients with either medial or lateral unicompartmental osteoarthritis, these types of knee braces can have a substantial impact on a patient’s activity by reducing the pain and swelling associated with arthritis of the knee and extend the life expectancy of the knee until such time that these new technologies can be applied.
Most unloader knee braces work in two ways, utilizing the same principle effect of removing stress of one of the two compartments of the knee joint. When the medial or inner compartment of the knee is affected, a varus deformity or bowing of the knee joint can be seen on x-ray and if severe, can be seen clinically when a patient is standing.
Likewise, with the lateral or outer compartment is affected, a valgus deformity or knock kneed develops. Some braces, like the Breg Fusion and X2K OA Knee Braces work by applied pressure directly at the knee joint in an attempt to correct the varus or valgus deformity and “make the knee straight”. This has the effect of reducing the pressure of the affected compartment of the knee and redistributing the weight to the brace and the other compartment.
Braces like the DonJoy Nano or OA Adjuster work by bending the thigh and leg into a straighter position, rather than exert direct pressure on the knee joint. This type of unloader knee brace works well with patients with severe arthritis, and palpable pain and pressure at the knee joint leve. In severe arthritis with patients suffering severe pain, the results can be quite instantaneous.
Over the last several years, single hinged arthritis braces have entered the market, with the advantages of being lighter weight and more comfortable to wear.
So how does a doctor or patient choose between a single hinged arthritis brace or dual hinged? And how do you choose between direct knee correction or thigh/leg correction?
The choice really depends on the patient and certain factors that would eliminate some of the choices you have.Typically younger individuals benefit from dual hinged braces as they provide added knee stability to protect the meniscus, collateral ligaments and ACL/PCL.
Active athletes and people participating in higher impact and contact sports have added benefits when utilizing a dual hinged brace. Older individuals or people with more sedentary lifestyles may benefit better with single hinged braces, due to the added comfort and fit of these devices.
Patients with substantial swelling in the knee, or knees that do not conform to standard off the shelf measurements may benefit from singe hinged braces, again to provide a better fit and less restriction of knee swelling.Newer models are designed for women, addressing a wider pelvis and increased Q-angle.
When choosing a knee brace, it is always best to consult with your treating doctor, therapist or healthcare professional. They will be able to determine which unloader knee brace is best for your situation based on clinical and radiological findings.
Going online and buying an arthritis knee brace without knowledge of your condition can make your situation much worse and increasingly painful. It is always recommended that if you go online to purchase an arthritis knee brace, that you choose a company that has experience in these types of medical products and can help guide you and your doctor in the right direction.