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Brace Solutions for Knee Osteoarthritis

 

The severe impacts of knee osteoarthritis

Osteoarthritis(OA) of the knee is a common medical condition, it mostly affects people above the age of 40 and older. The typical symptoms of Knee OA are painful and swelling. Besides, it will decrease the range of motion, which leads to functional disability and decreased quality of life among patients. Furthermore, it also carries heavy social costs from work loss, early retirement, and increase health care utilization.

 

Ultimate goal of OA knee management: functional improvement

Up to now, there is no solution for OA, therefore the treatment focuses on the pain management, functional maintenance and improvement, also ameliorate the quality of life. There are two options of treatments for OA knee: non-surgical and surgical management. Using knee braces is one of the non-surgical management and postoperative management, it not only supports the injured joint but also improves comprehensively physical movements. The use of knee braces is already recommended by NICE guidelines [1], Osteoarthritis Research Society International and other medical associations. [2][3][4]

Three types of knee braces and its clinical management

Soft braces are made from elastic materials which provide compression to knee joint. Tactile stimulation provided by soft braces will cause neural inhibition which leads to the reduction in pain. Increasing the temperature of skin after wearing a soft brace will decrease muscle spasm and improve regional blood flow. Stimulation of mechanoreceptors by soft braces can also improve joint proprioception and increase joint stability. 

 
Soft brace can help to improve
  • Proprioception
  • Joint stability
  • Skin temperature
  • Regional blood flow
 
Benefits

To increase tissue circulation and assist joint movement.

Unloading braces are made from rigid materials which provide corrective force to knee joint. The mechanical effects of unloading braces are increasing joint space, distracting compressive loads to the opposing compartment, and decreasing abnormal joint motion during knee movement. Unloading braces can also improve joint proprioception, stability and postural control.

 
Unloading brace can help to improve
  • Proprioception
  • Joint stability
 
Benefits

To reduce joint pain and restrict abnormal motion.

Rehabilitative braces are made from rigid materials which provide strong protection to post-operational joint. Rehabilitative braces help increase joint stability and prevent patients from further injury. In addition to protection, they can also improve joint proprioception and movement control.

 
Rehabilitative brace can help to improve
  • Proprioception
  • Joint stability
 
Benefits

To control joint range of motion and improve joint function.

Clinical recommendation

References:
[1] NICE. NICE guidelines: Osteoarthritis - Care and Management; 2014. Available at: https://www.nice.org.uk/guidance/cg177/chapter/1-Recommendations#non-pharmacological-management-2. Accessed May 24, 2017
[2] McAlindon TE, Bannuru RR, Sullivan MC, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22 (03) : 363–388
[3] Jordan KM, Arden NK, Doherty M, et al; Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003; 62 (12) : 1145–1155
[4] Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43: 1905–15.

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