Unloading Knee Braces: 5 Questions & Answers

Unloading knee braces belong to a special category of knee brace that shifts weight bearing pressure from one side of your knee joint to another. The key benefit of these braces is their ability to reduce pain and discomfort for individuals suffering the effects of knee osteoarthritis. As mentioned in an earlier post, patients suffering from this type of arthritis have worn cartilage on the ends of the bones in the knee, causing bone surfaces to come into direct contact with each other. An unloading knee brace, by shifting pressure from the injured side of the knee joint to the healthy side, can relieve pain and extend the period of time before the patient has to consider possible knee replacement surgery.

In this post, we consider five questions that may be on the minds of those who have been diagnosed with knee osteoarthritis and who may be considering an investment in an unloading knee brace.

How Do Unloading Knee Braces Work?

Unloading knee braces apply pressure to 3 points of the thigh in such a way as to force the knee to bend away from the painful side of the joint. They can either relieve pressure on the medial (inner) side of the knee or the lateral (outer) side. Some braces are versatile enough to allow the patient to switch them from one mode to the other, just by adjusting a hinge on the brace. However, in most cases, individuals using these braces have osteoarthritis in the inner or medial side of the knee. For these patients, knee instability causes the knee to wobble towards the inside of the leg, thus aggravating the discomfort of osteoarthritis. Unloader braces counter this tendency and redistribute pressure towards the outside of the joint.

How Do I know Whether An Unloader Knee Brace Will Work For Me?

As with most questions of this type, the main source of guidance should be your doctor. However, there are a few points that we can still make:

• Since these braces shift pressure either from the medial side of the knee to the lateral side, or vice versa, they will not be effective if you have knee osteoarthritis on both sides of the joint.
• They will be most effective if you have stage 1 or 2 knee osteoarthritis. Patients in stages 3 or higher will have more widespread damage to the knee joint and it will be more tricky to find a healthy side of the joint to which the brace can redistribute pressure.

Will An Unloading Knee Brace Halt Or Reverse The Disease?

Unfortunately, it will not. The only realistic goal of wearing this type of brace should be to reduce the rate of progression of the disease in order to delay the arrival of stage 4 osteoarthritis as long as possible. At stage 4, the only treatment option in most cases is knee replacement surgery, which is major surgery that is costly and requires extensive rehabilitation. Together with a properly designed exercise program and, for overweight patients, a weight loss program, an unloading knee brace can defer this unpleasant experience or even make it entirely unnecessary.

Where Can I Obtain An Unloading Knee Brace?

Traditionally you could have these braces custom made for you by an orthopedic specialist. For a knee brace of this type, you could expect to pay a price of $500 or more. However, off the shelf unloader braces are now available at lower prices. Before making your decision on where to obtain your brace and on its specific design, we strongly recommend that you consult with your doctor. It is particularly important for you to ensure that your brace is properly fitted, as this will ensure that it is comfortable to wear, This in turn will promote patient compliance and therefore the best long term results. A custom made brace will (by definition) ensure the best possible fit and the most comfortable wearing experience, albeit at a potentially significant additional cost compared to its off the shelf counterpart.

Another important consideration will be whether your brace has insurance coverage. Not all braces may qualify for coverage by your insurer and you should check with them before making your final decision, as insurance coverage can significantly reduce the net cost of acquiring an unloading knee brace.

Has There Been Any Scientific Analysis Of Unloader Knee Brace Effectiveness?

An article published by the American Journal Of Orthopedics  reports on the results of a study of 31 patients with knee osteoarthritis who were randomly allocated an loader knee brace or, alternatively, did not receive one. The study found that the sub group wearing a brace had significantly less pain and fewer arthritic symptoms than the other (control) group. They were also more able to engage in activities of daily living (e.g. bathing, toileting). However, there was no difference between the groups in terms of their ability to engage in sport and recreational activity or in their “knee-related quality of life”. The study concluded that “use of an unloader brace for medial compartment knee OA (osteoarthritis) led to significant improvements in pain, arthritis symptoms, and ability to engage in activities”.