Functional knee bracing
Knee braces may be used to protect a healing structure, support an unstable knee or redistribute load in osteoarthritis.
A practical functional classification includes:
- prophylactic braces - intended to reduce injury risk
- functional braces - used to support a ligament-deficient or reconstructed knee
- rehabilitative braces - limit or control motion during rehabilitation after injury or surgery
- unloader braces - redistribute compartmental load in unicompartmental osteoarthritis
Unloader braces in knee osteoarthritis
An unloader brace applies a corrective valgus or varus moment to reduce load in the affected compartment.
For medial compartment osteoarthritis, a valgus-producing brace attempts to shift load away from the medial compartment.
Indications
Most useful in patients with:
- predominantly unicompartmental tibiofemoral osteoarthritis
- correctable varus or valgus alignment
- activity-related compartmental pain
- desire to delay or avoid surgery
Limitations
- comfort and adherence are major limitations
- benefit varies between patients
- braces do not reverse established structural osteoarthritis
- severe fixed deformity is less likely to respond
Other brace uses
Functional or rehabilitative braces may be used after ligament injury or reconstruction, but the indication should be specific and should not replace appropriate rehabilitation.