How an Unloader Brace Helped Tom Increase Activity

This blog is a success story about Tom, a 42-year-old man who previously worked as a professional athlete and now works as a personal trainer in a private gym.

Due to a previous knee injury that developed into osteoarthritis, specifically medial compartment osteoarthritis, he experienced morning stiffness, severe pain during prolonged standing and limited mobility throughout the day. Even exercising caused discomfort and disrupted his sleep.

The combination of symptoms reduced his function and greatly impacted his quality of life.

The patient consulted a surgeon for potential surgical options but was deemed too young for a total knee replacement and was encouraged to try conservative treatments.

Tom contacted Orthotics Plus to discuss his situation and treatment options.

Initial Visit to Orthotics Plus

Opting for conservative treatment, the patient visited Orthotics Plus, where an assessment led to the recommendation of an unloader knee brace.

Unloader braces refer to a family of braces which aim to reduce load through either the medial or lateral compartment of the knee. The Unloader One brace by Ossur is Orthotics Plus’ preferred option due to its effectiveness, user-friendliness, and research supporting its use.

Moreover, the brace comes with a 30 day satisfaction period, which provides a lower-risk option for Orthotists to prescribe in case of patients not liking or responding well to it.

Tom has excellent skin integrity, which is a factor to consider when prescribing an everyday device.

Overall, the unloader knee brace proved to be a well-fitting, comfortable, and effective treatment pathway for knee Osteoarthritis.

Adjustment Period & Feedback

The patient returned after one week of use to have his Unloader Knee Brace adjusted.  The patient said

“I am blown away with the results”

Tom stated that his pain was almost gone entirely. He was able to exercise and do a lot more. He felt like he was able to play with his kids more, and experienced no pain at night while trying to sleep.

Customising an Unloader Brace to Address Specific Anatomy and OA Symptoms

Osteoarthritis (OA) is a complex condition whereby due to excess load or reduced healing capacity the protective cartilage which cushions bone ends in an area wears away.

Unicompartmental OA of the knee typically occurs in younger patients when the patient has had a previous injury or damage to the knee, has very poor biomechanics or has been carrying excess weight. These factors cause the rate of damage of the cartilage to exceed the rate of healing and the cartilage will wear away over time, resulting in inflammation, swelling, and pain in the knee.

By definition, unicompartmental OA is ‘one sided’ referring to either the medial or lateral compartment of the knee (inside or outside respectively).

An Unloader knee brace can help by reducing some of the load through the painful compartment and adding it to the healthier side, allowing the inflamed area to heal and ‘settle down’. This results in less swelling, pain, inflammation, and an increased ability to move.

Unicompartmental OA is typically diagnosed through a combination of physical examinations and imaging studies. During a physical exam, a clinician will assess the knee for any signs of swelling, tenderness, or limited range of motion. They may also ask about the patient’s symptoms and medical history.

Imaging results, such as X-rays or magnetic resonance imaging (MRI), can help confirm the diagnosis of unicompartmental OA. X-rays can show signs of cartilage loss, bone spurs, and joint space narrowing, while MRI can provide more detailed images of the joint and surrounding structures.

It’s important to note that the Unloader brace must be fitted by an Orthotist or a qualified individual, as proper fitting is crucial for optimal effectiveness. This involves selecting the correct leg, size, and compartment of the brace. The unloading straps must also be balanced for both comfort and unloading. Straps that are too tight will unload well but won’t be comfortable, while those that are too loose won’t unload well.

Patient Education

As Orthotists, we aim to provide our patients with the knowledge to adjust their unloader knee brace independently.

While we set it up initially, we believe that patients are the best judges of how tight or loose the brace should be. Therefore, we educate them on how to make fine adjustments using the BOA dials on the brace.

We also have set protocols for wearing and scheduling, which we adjust based on the patient’s age and level of support needed.

Our ultimate goal is to ensure that patients feel comfortable and confident wearing their unloader knee brace and have the knowledge to make any necessary adjustments themselves.

Monitoring the Long Term Effectiveness of the Unloader Knee Brace

In most cases, patients immediately feel the benefits of wearing an unloader knee brace.

When appropriately prescribed, the brace will generally provide immediate relief from pain, and this relief often increases for up to six months as the inflammation subsides and the area ‘settles down’. These changes have been measured by MRI cartilage mapping studies.

A typical pattern we see is that the patient’s pain usually drops off rapidly in the first 2 weeks and then continues to decrease gradually over the next six months, plateauing at that point. This is obviously dependent on the patient wearing the brace consistently.

To evaluate the long-term results of wearing the brace, our Orthotists typically ask patients about their pain levels, sleep patterns, and ability to exercise without pain.

Patients may report a significant reduction in pain from, for example, 7/10 pain to 2/10 pain, or an increase in the distance they can walk without experiencing pain, or reduction in pain medications used.

The extent of pain relief will vary depending on the patient and their unique presentation.

Results for Mobility, Effectiveness and Quality of Life

As Tom’s pain reduced, he was able to increase his work hours and resume exercise, which is excellent for strengthening the muscles around his knee.

Increased knee strength leads to better control, which often results in less pain, creating a virtuous cycle.

Additionally, improved sleep quality is essential for mental health and helps manage pain, promoting recovery and leading to even less pain the next night. He was even able to enjoy playing with his young kids more.

Overall, his experience with the Unloader knee brace has been positive.

What Tom Has to Say:

“The knee’s doing so well… I’m still completely amazed at how good it is”.

Tom, Orthotics Plus Patient

Contact Orthotics Plus for an Assessment Today

Are you struggling with knee pain or instability? Contact Orthotics Plus today and take the first step towards receiving appropriate treatment.

  • Whether you have a specific diagnosis or need advice on finding the right brace, our team of Orthotists are here to help
  • We are highly experienced with Unloader Knee Braces which are suitable for those with unicompartmental knee osteoarthritis
  • We are NDIS registered
  • Our clinicians are university trained and possess a minimum of 10 years of experience

Orthotics Plus is ready to provide you with caring, conservative management for your knee condition, contact one of our Melbourne clinics today.