Posts tagged bracing
Will Bracing Help My Knee Arthritis?

Knee arthritis is a painful condition affecting middle age to older adults. Symptoms of stiffness and joint pain lead to decreased mobility, strength, and function within this population of patients. Physical Therapy treatments consisting of manual therapy and exercise remain a first line treatment for this condition. When combined with exercise, weight loss, medication, and injections can further reduce the symptoms of arthritis. We are often asked about the utilization of knee braces for this diagnosis. Bracing has been shown to be helpful within this population, but should be used sparingly due to the negative effects of this treatment on both knee mobility and strength. In particular, one sub group of patients with knee arthritis may benefit the most from this intervention.

The knee joint has two main weight bearing compartments, medial and lateral, which make up the inside and outside regions of the knee respectively. Arthritis contained to the inside compartment, most common among males, has been shown to respond to an unloading brace designed to transfer forces to the lateral or outside compartment. Gohal and colleagues reviewed the available evidence on the utilization of lateral unloading braces for patients with medial compartment arthritis (Sports Health. 2018). Authors reviewed 31 studies of 619 patients to determine the effectiveness of this intervention for patients with medial knee arthritis. They found knee unloader braces were significantly more effective than neoprene sleeves and neutral braces for relieving pain. Conversely, the effects of these braces on function was less clear and the authors called for additional larger randomized controlled trials to support their use.

No Benefit of Post Operative Bracing after ACL Surgery
ACL-bracing-post operative-knee injury

Post operative immobilization is often utilized after ACL surgery in an attempt to support the knee joint.  The reasoning behind the bracing includes reducing abnormal forces across the knee, patient comfort, and reducing the risk of injury to the recently repaired tissues.  Research has currently not found a strong benefit of early post operative bracing for patients undergoing ACL surgery.  

A recent article was published in the Annals of Physical Medicine and Rehabilitation analyzing the effects of early post operative knee bracing in patients status post ACL surgery (Bordes et al. 2017).  Authors analyzed 969 patients over a two year period who underwent ACL surgery for complications and brace use.  Brace use was categorized as rigid brace, limited range of motion brace, or no brace conditions.  The authors reported no beneficial effect of bracing in the first month after ACL surgery, but reported greater loss of range of motion among patients using a rigid brace.  Based on this article, post operative bracing may be best utilized based on a patient's presentation and preferences versus being utilized across the board in all patients undergoing ACL repair.