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Knee Braces - An Experience with an Orthotist

  • Published: 2011-08-26 : Author: Wendy Taormina-Weiss
  • Synopsis: Information on visiting an orthotist to obtain knee braces for osteoarthritis and bone degeneration.

Main Document

Information on visiting an orthotist to obtain knee braces for osteoarthritis and bone degeneration.

Yesterday found my husband Tom visiting an orthotist with the goal of obtaining a pair of knee braces. He has osteoarthritis and bone degeneration in both of his knees, and after experiencing surgery to remove the cartilage and repair a torn meniscus in both of them, he has been very wobbly. He has already fallen through a puppy gate, breaking it, because his knees gave out and the neoprene sleeve braces he has been using are not providing enough stability.

The orthotist was friendly, kind, and paid for by the Veterans Administration. He was also very informative, presenting a good amount of information and pointing us towards further information. Knee braces apparently come in a number of different designs, although most of them are made of a combination of firm yet flexible materials such as metal or plastic, which provide support. Knee braces are also made of products such as mold-able foam or synthetic rubber used for positioning and padding.

The knee braces Tom is receiving are a kind known as, 'unloading,' braces because he has osteoarthritis as his main diagnosis. Unloading knee braces are used to counter faulty knee mechanics that lead to further joint damage. A knee without osteoarthritis is aligned so the force of a person's weight falls evenly over their inner and outer joint compartments. The reality of the situation is that most people's knees do not. For many people, either one or both of their knees rotate a bit inward, something that places extra stress on one side of the knee joint.

Image of an X-ray of two knees; one with and one without osteoarthritisIn Tom's case this is just the opposite - his knees rotated outward for the entire twenty-four years he provided care for others, aggravating his knee joints. In people who have osteoarthritis, the rotation inward or outward of the person's knee joint is exacerbated. The space provided by the person's cartilage in their knee becomes lost and the space in their knee joint narrows causing an increase in the loss of alignment of the knee joint.

Knee braces help to reduce rotation of a person's knee by pushing their knee in the opposite direction. What this does is take pressure off of the portion of their knee that is the most affected by osteoarthritis. Bonus? It also helps to relieve the pain! Tom has been taking medications such as Tramadol and Lyrica to help with the pain he experiences. Another bonus? Knee braces can help people like Tom whose knees feel like they are going to buckle to stand and move around more confidently.

The osteo specialist manipulated Tom's legs, feet, and knees. He also took measurements around his lower legs and thighs. He has strong leg and thigh muscles and won't fit an off the shelf brace. He needs a custom made pair that will take a couple of weeks to arrive. When Tom groaned about the wait to get them the osteo specialist mentioned that those muscles were most likely the only reason Tom is still walking at this point, and to be thankful.

Knee braces are not a form of treatment of themselves, although additional things such as medications, physical therapy, or surgery are. Knee braces may be an option for people with osteoarthritis if:

Image of a person experiencing knee surgeryYou want to put off knee surgery
You don't want to experience knee surgery
You have medical issues that make surgery unsafe
It involves the medial compartment in your knee joint
The knee pain limits your activity despite pain medication and other forms of treatment

There are some risks involved with using knee braces as well. For example, it can take time to get used to wearing the braces - maybe up to a month. While it isn't common, some people do experience some knee swelling during the first six months they wear knee braces. Others experience some skin irritation, with skin that becomes red and irritated; something that can be caused by a poorly-fitting brace. Some people also do not benefit from wearing knee braces; yet others report a decrease in pain with increased knee function.

Not everyone is a veteran, so what is involved with getting knee braces? A prescription from a doctor is needed for certain kinds of knee braces. It is important to remember that Medicare and other forms of health insurance do not always cover the costs of knee braces. Insurance companies or Medicare may be very particular about the specific type of knee braces they do cover. Knee braces range in price from a few hundred dollars to greater than a thousand dollars each for custom braces. You will also need an appointment with an, 'orthotist.' An orthotist designs, builds, and fits braces and additional devices with the goal of improving function in people who experience orthopedic issues.

There are apparently only a few studies that have compared the different styles of knee braces with each other. What this means is it is always your best choice to let your preferences be known while you are working with your orthotist, and to let take their advice while making a choice. Overall, every knee brace belongs in one of two categories:

Image of an Off the Shelf knee braceKnee braces that come, 'Off the Shelf':

Off the shelf knee braces come in a number of standard sizes. Their designs allow you to make adjustments to the pressure you apply to your knee depending upon the amount of support you need for various activities at different times during the day. If you are lucky enough to find an off the shelf knee brace that fits you well, you can take it home or have it shipped to you.

Custom knee braces:

Custom knee braces are ones that are both designed and built to fit a person's exact measurements. It takes a certain amount of time to build them, meaning you will have to wait a few weeks for them to arrive before you receive them. When they do arrive, your orthotist will check to ensure they fit appropriately before you take them home.

When Tom went in for his knee brace fitting, the orthotist wanted to make sure the braces he would receive would fit right. He examined Tom's knees, asked about the history of his osteoarthritis, and the symptoms he was experiencing. The orthotist also wanted to know what kinds of activities Tom was doing or would like to do and how the knee braces might help. He watched Tom walk a short way to examine how his knees were functioning, and then took a number of different measurements of his legs so custom braces could be ordered.

Then the orthotist talked to Tom about the different kinds of braces available. He explained how each design differs from the other, and which might be the best for Tom. There were no off the shelf knee braces that would fit Tom in the office, but the orthotist did have different publications presenting braces for Tom to look at. They finally made a choice and the braces are now on their way.

Editors Note: Orthotics is a specialty within the medical field concerned with the design, manufacture and application of orthoses. An orthosis (plural: orthoses) is an orthopedic device that supports or corrects the function of a limb or the torso.

An orthopaedic brace, "appliance", or simply brace is an orthopaedic device used to:

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