Your comprehensive source of information and advice on the use of Unloader Knee Braces to treat osteoarthritis of the knee.

Use the category menu on the right to locate articles filled with handy tips on selecting, using and buying an unloader brace.

Find out if you have the type of arthritis Unloaders are designed to treat. Compare the different types of brace, learn about the different features, and find a summary of the published research documenting the effectiveness of Unloader braces.

Unloaderkneebraces.com is a valuable resource for anyone considering this non-surgical treatment for knee arthritis.

Technorati Tags: knee arthritis, knee osteoarthritis, unicompartmental, unloader knee brace, unloading knee brace

Many people expect Unloaders to be enclosed braces but the are not because they do not need to be. In order to apply the required force to the knee, Unloaders require a rigid frame.
Apart from the straps that hold the brace to the leg, no other skin is covered. This automatically makes them more pleasant to wear than fully enclosed braces in warmer environments.

A Typical Enclosed Knee Brace

Those living in tropical climates or even temperate areas with warm summers should consider getting an extra set of softgoods when they purchase an Unloader Knee Brace. This allows you to “Wash one, wear one” and prevent your brace from smelling. The need to wash the liners and straps of a brace is directly related to the amount of perspiration.
In some areas, a brace may need its liners changed once a month in Winter, but every second day in Summer.

You can often get a significant discount if the replacement liners are bought at the same time as the brace and at the very least you will save on postage and handling.
The bottom line is that if your climate is warm or hot, you will eventually end up getting an extra set of straps and liners. Your life will be made much easier if you do this from the start.

Unloader - Cooler but spare liners still required when its warm

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Every brace has its own set of instructions for application but understanding the anatomical shape of the leg can help get your brace to stay in the right place.

Braces fall down for two reasons. The first, as mentioned, is gravity. The second is the conical shape of the leg. We start off wide and get narrower as we go down.This means that no matter how tight you have the majority of straps on your Unloader, your leg is still narrower just beneath the strap. Even straps painfully tight will not stop the brace from slipping.

The one exception to this rule is just below the knee joint. This is the only part of the leg that flares out and gets wider. The reason is the bulk of the calf muscle.

If you want to stop your Unloader from slipping down you need to focus on the strapping immediately below the knee but above the calf bulk. All other straps will be of little or no use in helping keep the brace fixed to the leg.

Some braces have a special strapping configuration at this level to help maximize the effect. The Donjoy OAdjuster has what they call an “Anti-Migration” strap – a full circumference strap that sits above the calf and is their main weapon against brace slippage. Regardless of the type of brace, strapping above the knee has little ability to hold the brace up so don’t get frustrated and cause discomfort by making these straps overly tight.

Check your brace fitting instructions again but pay particular attention to the strap just below the knee. 9 times out of 10 this will solve your problem.

Make use of the calf to stop your brace slipping down

Technorati Tags: brace slipping, donjoy, donjoy oadjuster, fitting instructions, knee osteoarthritis, slipping, stop brace slipping down, unloader knee brace

It has been well documented that fractures through the joint surface lead to the early onset of arthritis and ACL rupture is also a known risk factor.

The cases that are more difficult to explain are those involving (relatively) young professional sportsmen who have suffered no significant prior injury. The frequency of arthritis in this population suggests that moderate to high level repetitive actions may increase the risk of osteoarthritis.

Recently, Australian sportsman Nathan Bracken appeared on their version of Dancing With The Stars wearing an unloader knee brace. A former international representative fast bowler in the sport of cricket, his career had ended due to knee degeneration (see here).

Although knee replacement operations are generally very successful,  surgeons are reluctant to replace joints in young people due to the limited lifespan of replaced joints (for more on this topic see Too Young For a Knee Replacement and note the feisty comments section).

It would be a brave professional sportsman who retires at 38 and lines up for a joint replacement without investigating the non-surgical management of osteoarthritis.  Most will find that ceasing their professional involvement in a sport will decrease their symptoms but the damage has been done and by their mid 40′s many are investigating the various treatment options.

The advice I give sportsman is to make the most of every link in the chain before major surgical intervention. This means trying an unloader knee brace, building quad strength, losing weight and  managing pain.

Physical Therapists and Doctors are always the last to line up for surgery and sportsmen should ask themselves why.

Technorati Tags: arthritic knee, arthritis of the knee, knee osteoarthritis, sport, unicompartmental osteoarthritis, unloader knee brace, young sportsmen

This site contains a lot of information on the various features of the different unloaders but what people really want to know is:  ”Which is the best unloader brace?”.

Each manufacturer (of course) has nothing but great words to say about their own products and their websites are usually full of testimonials. Independent opinion is much more difficult to come by, and to my knowledge there has only been one article published in a respected journal that specifically compares different unloader knee braces. It only had a small number of subjects but it is the best independent information available to date.

Published in the Journal of Bone and Joint Surgery in 2005, the article  ”In Vivo Three-Dimensional Determination of the Effectiveness of the Osteoarthritic Knee Brace: A Multiple Brace Analysis” looked at 5 people with medial compartment osteoarthritis.

Baseline measurements were taken and then each was studied walking on a treadmill. As a control they were then reassessed wearing an ACL brace that appears similar to an unloader but does not physically unload the joint.

Next they were fitted with each of the 5 chosen unloaders and evaluated using  fluoroscopy.

The five braces studied were:

Bledsoe “Thruster 2″

Donjoy “OAdjuster”

Breg “Tradition X2K”

Innovation Sports “OAsys”

Generation 2 “Unloader Spirit”

The Results

Two braces consistently were shown to unload the affected part of the joint, the other three had variable results and at times were less effective than the ACL brace that was the control.

“The present study has demonstrated that articular separation of a degenerated knee compartment can be achieve consistently with two braces, but not as effectively with the other three braces tested in this study. Therefore, there is a difference in the results produced by off the shelf OA braces.”

So, without further ado…..

The Top 2:

The Thruster 2 by Bledsoe

The OAdjuster by Donjoy

It should also be noted that due to corporate acquisitions, Ossur now owns both Innovation Sports and Generation 2 with the” OAsys”  and the Generation 2 “Unloader Spirit”  still available as Ossur products and (and the Spirit technology was used in the development of the Ossur “Unloader One”.

To read the article referenced above, click here.

This article is 6 years old at time of writing and more research is needed, particularly into the latest generation of unloaders. Things have moved on since then but the mechanism by which these braces unload the joint is similar to 2005.

This study (until made obsolete by a more comprehensive piece of work) is a useful guide that helps consumers compare unloader knee braces.

Technorati Tags: best unloader brace, bledsoe, compare, compare unloader knee braces, donjoy, unloader brace, unloader knee brace

The Discussions tab has a list of case studies showing the type of people using Unloader braces. There is also a section where you can ask any questions you may have relating to the use of Unloaders for different levels of arthritis and for different levels of activity.

The wall has plenty of blog-style posts about the different Unloaders available as well as general news of developments into the treatment of osteoarthritis of the knee.

Please drop by and have a look, ask a question, and don’t forget to like the page if you found it of use.

To visit the page, click here: Unloader Knee Braces

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Some injuries are known to increase the risk of future knee arthritis – one example of this is an Anterior Cruciate Ligament rupture. The medial mensicus and medial ligament are frequently injured at the same time as the ACL and this can further increase the risk of early wear. Anyone who has knee osteoarthritis as a result of this type of injury may be looking for an unloader knee brace that also offers protection to the previously injured ligaments.

In this situation, one unloader instantly springs to mind. The OAdjuster by Donjoy is one of the few unloaders with bilateral hinges and as such offers good collateral ligament protection.  Importantly however, the unloader is based on their ACL bracing range and as well as unloading the joint offers the same protection as their successful cruciate ligament devices.

Anyone looking for  an unloader that also provides ligament protection for high risk activities such as skiing should put the OAdjuster at the top of the list.  It is also a suitable choice for anyone with mild arthritis looking for ski protection who thinks they may need the benefits of an unloader in the future.

For more information on the OAdjuster, click here.

The OAdjuster unloads but also protects the ACL/MCL/LCL

Technorati Tags: ACL, LCL, ligament protection, MCL, skiing, unloader knee brace

It features a pull-on sleeve design and a single hinged upright located on the opposite side to the worn compartment.

Who it is suitable for:

Those who don’t usually walk more than 1 or 2 miles a day

Those who manage OK around the house but need a little extra support when away from home.

Those who are able to apply a pull-on brace.

Who it is not suitable for:

Those unable to reach far enough to get a pull-on brace on.

Those with advanced (Grade IV) osteoarthritis (unless they are unable to use more advanced braces).

Those with extensive quadriceps wasting – It is difficult to get a satisfactory fit when the widest point of the leg is the knee joint itself  (The usual proportion is thigh circumference > mid knee circumference which is similar to calf circumference.)

The unloading force the OA Lite provides is built into the frame of the hinge. If this force is too much and it become uncomfortable, the hinge can be bent to decrease the load. The unloading force can also be increased if required by bending the other way.

Unlike some of the more complicated unloader knee braces, the Donjoy OA Lite is easy to use and as long as they understand the principle of bending the hinge to alter the unloading force, it can be fitted by anyone.

To find out more about the Donjoy OA Lite or to buy one online, click here.

The Donjoy OA Lite

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There are plenty of general knee supports for widespread osteoarthritis but in terms of braces that provide a mild to moderate unloading force, there are few.

Braces in this category are often described as braces for “Every day living” and are suited to those who have knee pain but relatively low functional requirements. Anyone who mainly mobilizes around the house with the occasional outdoor excursion fits into this category.

The OA Lite is an example of this type of brace. It has a pull on design (slide on over the foot like a sock), single hinge and is easy to fit. The hinge is on the opposite side of the knee to the affected side and the unloading force is built in to the hinge. If this force is too strong (or not strong enough), the hinge can be bent to adjust it.

This brace is an ideal selection for those with moderate knee arthritis if their knee remains within the “usual” proportions. The OA Lite is sized by a thigh circumference taken 6 inches above the middle of the kneecap. If your leg has suffered significant quadriceps wasting as a result of your arthritis the brace may not fit or be able to unload the joint.

As a general rule: If the circumference of the leg across the middle of the knee is greater than the circumference 6 inches above this point, an “off the shelf” brace will struggle to fit and be effective.

If the thigh measurement is greater than the knee measurement, the OA Lite is a good choice. For more information on this brace, click here.

More general resources on Unloader Knee Braces include:

• Arthritis Treatment – Unloader Knee Braces | Osteoarthritis Blog – The majority of patients who try on an unloader knee brace will experience an immediate reduction in pain. The three point pressure system acts like a fulcrum. It is a biomechanical solution to a biomechanical problem.

• What Is an Unloader Knee Brace? | Unloader Brace For Knee – An unloader knee brace is designed to treat osteoarthritis. It is not favorable for everyone but can be a indispensable tool for the right person. The following questions can help decide if this form of rehabilitation will be of advantage to you. …

• Unloader Knee Brace | Braces Braces – Degenerative Joint Disease affects millions of Americans and with an aging baby boomer population will most certainly become more of an issue as we try to maintain a healthy lifestyle, and battle against the affects of our …

Technorati Tags: basic unloader brace, cheap unloader brace, inexpensive unloader brace, oa lite, Simple unloader Brace

In this case a general knee support can offer pain relief and give a feeling of increased stability to the knee. This type of knee support can also be used by those suffering from Rheumatoid arthritis.

General knee supports consist of a pull on sleeve that offers full circumferential compression. The better models also offer support to the kneecap and allow for a good range of motion to permit everyday activities.

The Genutrain Elastic Knee Brace is a good example of this type of support.

Unlike Unloader Knee Braces, which some elderly users find too complicated, it is very easy to use and does not require the manipulation of straps which can be difficult for those with arthritis in their hands and wrists.

For more on this knee support (including sizing information), click here.

Technorati Tags: basic knee brace, elastic knee brace, knee support, widespread arthritis