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Options for Knee Orthoses

There are many different types of knee braces out on the market nowadays. With so many viable options, how do you know what brace is right for you? Our article below is a good starting point, but it’s also vital to discuss your needs with your provider.

Knee braces can be prefabricated or custom-built, made as a simple neoprene sleeve, or built with a rigid frame with hinges incorporated. The main goals of any brace are simple: to provide compression, or stability and support, or to correct excessive motion that will strain the ligamentous structures inside the knee joints. The braces can be further classified as functional, unloader, prophylactic, patellofemoral, rehabilitative, or a simple sleeve. (1)

Bracing For Knee Instability

The ligamentous structures of the knee work with the surrounding muscles to provide stability to the joint. A blow to the knee might tear one or more ligaments, compromising the function of the affected side. In this case, a knee brace provides stability by controlling excessive motion exerted on that joint. A knee brace is also used post-surgery in the event of a reconstruction of a ligament. In this case, the brace acts as a support during the healing process.  

A neoprene sleeve (picture 1a) can be used in acute injuries to provide compression, and potentially prevent and reduce joint effusion (1). Padding (picture 1b) can be incorporated in the knee sleeve to stabilize the patella/knee cap.

A brace with a rigid frame and joints controls the knee from a side-to-side and/or front-to-back motions. It provides stability to the knee after an injury, such as an ACL tear. This type of bracing is also used to support the knee joint after a reconstructive surgery by limiting excessive motion of the affected ligament.

Offloading Pressure

Offloading bracing is beneficial for a patient who needs to relieve pressure, as its name implies, in one compartment of the knee joint. The brace helps the patient shift the weight off the affected compartment of the knee. (Figure 1-Anatomy of the knee joint)

Picture 2a depicts a tear of the lateral meniscus. In picture 2b, there are 3 forces applied to the knee: two forces directed the proximal and distal aspects of the affected side, and the 3rd counterforce is coming from the opposite or medial aspect of the knee. These 3 forces work together to open up the lateral cavity, reducing the pressure against the structures to control the pain.

A rehabilitative brace allows for controlled and secure motion of injured or surgically repaired knees. (1)

Choices, Choices, Choices

As technology continues to evolve, these braces can incorporate metal stays such as in picture 1a, a metal frame as seen in picture 2b, or even 3D printed (picture 3). They can also incorporate single or double joints. Whatever the available technology, we cannot possibly stress this enough: The chosen option should match the patient’s needs and goals, diagnosis, patient’s activity level, integrity of the knee joints structures, shape of the lower extremity, and duration of the treatment.

Bracing an injured knee may help delay surgery in some cases. For other patients, it might be a temporary treatment for an injury. No matter what, your orthopedic doctor will properly diagnose and set up the treatment plan, and your orthotist will help you with the appropriate bracing needs. And finally, your therapist will play a great role during rehabilitation.

"There are many different brace manufactures and designs, so the involvement of an orthotist is useful to provide the appropriate brace option including more custom designs." (1)

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  1. Kemker BP 3rd, Kankaria R, Patel N, Golladay G. Hip and Knee Bracing: Categorization, Treatment Algorithm, and Systematic Review. J Am Acad Orthop Surg Glob Res Rev. 2021 Jun 7;5(6):e20.00181-12. doi: 10.5435/JAAOSGlobal-D-20-00181. PMID: 34096901; PMCID: PMC8189624.
  2. Google images 2022

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