As medial compartment osteoarthritis is more common than wear in the lateral compartment, the majority of research papers and brace manufacturers promotional material is on medial unloaders.
Many people with lateral compartment osteoarthritis are unaware that just about every major brand has both medial and lateral versions of their braces available.
Certain types of injury have been associated with a significantly higher risk of developing osteoarthritis at an early age.
Anterior Cruciate Ligament rupture is one such event, but potentially much more serious is a fracture that passes through the knee joint.
Known as an intra-articular fracture, it can lead to rapid wearing of the joint surface and early onset knee osteoarthritis.
Unloader Knee Braces can be used by people who are both Knock-kneed and Bow-legged.
As the knee becomes progressively more worn by the osteoarthritis disease process, the angle at the knee slowly increases.
Although the primary reason for wearing an Unloader Knee Brace is to decrease pain, some people hope the brace will also straighten their knee as well.
An Unloader does apply a force pushing against this angulation but there is generally little change in overall leg position. The brace does enough to relieve pain but the force required to physically straighten the leg would be so great it would be painful to wear. Modern unloading knee braces are more subtle in their workings and are comfortable to wear. If you are looking to see a large leg angle correction you will likely be disappointed.
Medical jargon can be confusing but it gets easier if you break it down.
Osteoarthritis is the "wear and tear" type of arthritis that commonly occurs in weight bearing joints.
Unicompartmental is a word that is unfamiliar to most.
"Uni" here means 'one'.
In medical terms the knee is divided up into three compartments.
The joint between the thigh bone and shin bone is divided into two compartments. The medial compartment is the inside half of the knee joint. The lateral compartment is the outside half. The third compartment is the articulation between the knee cap and the thigh bone.
Unicompartmental osteoarthritis therefore means the arthritis is only present in one of the three compartments. Most commonly it is the medial compartment and when the wear becomes severe it can result in the knee becoming bow legged.
This is the most common type of osteoarthritis treated with an unloader knee brace.
Unloader knee braces are often used by those who have sustained a tibial plateau fracture and want to return to sports such as skiing.
A tibial plateau fracture is a break through the top of the shin bone at the knee joint.
It is an "intra-articular" fracture meaning that the break goes through the joint surface itself. This leads to a significantly higher risk of osteoarthritis. Because of this, active people are using an unloader knee brace to decrease the load on the affected compartment when they return to demanding sports like skiing.
Many surgeon explain to their tibial plateau fracture patients that they will need a knee replacement at some time in the future. The only thing that is unknown is when. Anyone looking to test their knee in more physically stressful sports should investigate non-operative ways of decreasing the forces through their knee.
Those living in warm climates often ask how hot they are going to be wearing an unloader knee brace in summer.
Modern unloaders are not enclosed braces and as such are much cooler to wear than a neoprene sleeve or other type of covered brace.
They are not as cool as wearing nothing but many are surprised.
In very hot areas it is often wise to buy an extra set of padding and straps so you can wash one set while the other is on the brace. Rotating them makes a huge difference and extends the life of the softgoods.
Knee Osteoarthritis is a chronic condition and unloader knee braces need to be able to provide long term support. The big manufacturers all have a warranty on their flagship products:
The Donjoy OAdjuster comes with a one year warranty on the frame and hinges and six months on the softgoods.
The Ossur Unloader comes with a two year frame and hinge warranty and six months on the softgoods.
The Bledsoe Thruster has 3 years on the hinge, one on the frame, and 90 days on the softgoods.
All of these braces have been around for a number of years and have shown themselves to be up to the job long term.
