How to Choose the Best Knee Brace for Arthritis

Man with Knee arthritis brace tying shoe

Knee bracing solutions are increasing in popularity, particularly with the advent of tri-compartment unloading technology. This recent advancement in knee bracing technology now provides all knee osteoarthritis patients the opportunity to relieve their knee pain. There are more product choices than ever before and as a consequence, more diligence is required to ensure you select the product that best fits your situation. Choosing the wrong knee brace for arthritis can lead to frustration and disappointment as it will provide only a slight benefit. Choosing the right brace could afford you with life-changing increases in mobility, reduced pain, and confidence. What brace is right for you? It all depends on the pattern of knee arthritis you have.

Arthritis patterns influence knee brace selection

Knee Braces for Arthritis – Location Location Location!

Your doctor may have told you that you have knee arthritis, but that’s only half the story. Arthritis attacks your knees in a variety of different patterns. Your knee has three distinct areas that are under immense pressure during joint movement. In medical jargon, these pressurized contact zones of the joint are known as compartments. Compartments are where load transfer occurs between bones. Bone in these areas is coated with articular cartilage that provides lubrication — reducing friction during movement. There are three compartments within the knee joint: (1) patellofemoral compartment, (2) inside tibiofemoral compartment and (3) outside tibiofemoral compartment. Knowing the affected compartment(s) will help to determine what type of knee brace for arthritis will work for you. 

How do Knee Arthritis Braces Work?

Most general-purpose knee braces are limited in their ability to relieve arthritis symptoms. The rigid plastic frame provides increased lateral stability which may improve balance. While this can help, it does not address the root problem causing the pain in arthritic knees. Bone on bone pressure and increased friction due to cartilage loss are the primary factors leading to arthritis joint pain. Knee braces designed specifically to treat arthritis reduce pressure in areas of the knee joint most affected by the disease. In doing so, the bone on bone pressure and friction is decreased. This allows users to move more easily with less pain. These arthritis knee braces are called “unloader knee braces” because they actively unload pressure within the joint.

Two types of unloader knee braces for arthritis

Types of Knee Arthritis

There are two main categories of knee arthritis: multi-compartment and uni-compartment. “Multi-compartment” implies that you have arthritis in more than one compartment while “uni-compartment” suggests that only a single area of the knee joint is affected. There are two subtypes of uni-compartment osteoarthritis that are important to distinguish between: patellofemoral and tibiofemoral. Patellofemoral knee arthritis indicates that the cartilage behind your knee cap has been damaged. Tibiofemoral arthritis refers to the cartilage between the top of your shin bone (tibia) and the bottom of your thigh bone (femur). 

What Type of Knee Arthritis Do I have?

Your doctor can help you definitively determine which pattern of knee arthritis you have. This is done via diagnostic imaging such as an X-ray or MRI. Using this information, specialists can determine which compartments have bone spurs developing and where bone on bone pressure is occurring. 

Don’t know what type of arthritis you have? The statistics here can be informative and provide helpful hints as to the pattern of arthritis in your knee. Multi-compartment knee arthritis represents close to 65% of total cases5-10. Of these, 90%9  of cases involve the patellofemoral compartment. Multi-compartment arthritis is even more common in those suffering from very severe knee arthritis (87%)11. Of those with uni-compartment arthritis, the patellofemoral joint is the most commonly affected structure7-10. Does your knee arthritis bother you most when squatting, kneeling and bending? If so, there is a good chance the patellofemoral compartment is affected.  Pressure in this area of the knee increases dramatically as the joint flexes. Remember to consult your doctor before making any final decisions regarding your knee arthritis!

Knee Braces for Arthritis – What do I Choose? 

There are two types of unloader knee braces for arthritis. Uni-compartment unloader braces use tension strapping systems to pull the knee joint more to one side or the other. This allows pressure to be reduced in either the left tibiofemoral or right tibiofemoral compartment. By shifting pressure from the arthritic compartment to healthy compartment pain is reduced. This type of brace can provide significant benefit for those with isolated tibiofemoral osteoarthritis. Approximately 6%7,11 of osteoarthritis patients have this particular pattern of degeneration.

Tri-compartment Unloader knee braces use a spring hinge system, to distract and decompress the knee joint as it bends. In doing so, the internal forces and friction between the pressure zones are reduced in all three areas simultaneously by up to 64%12. This is analogous to the therapeutic effect of dramatic weight loss on knee pain and function. Tri-compartment unloader knee braces for arthritis alleviate pain by reducing pressure across the entire joint in the same way losing 40 lbs of bodyweight would decrease joint stress. This is the only type of knee brace designed specifically to help with multi-compartment and isolated patellofemoral knee arthritis. Combined, approximately 94%7,11 of patients have one of these patterns of knee arthritis. To learn more about this technology watch the video below.

Let Us Help You! Call 1.877.209.8780 to Speak to a Bracing Specialist

What’s Next?

Guide to Managing Knee Arthritis Without Surgery or Painkillers

Top Five Unloader Knee Braces

References

  1. Jevsevar, D. S. (2013). Treatment of osteoarthritis of the knee: evidence-based guideline. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 21(9), 571-576.
  2. Fernandes, L., Hagen, K. B., Bijlsma, J. W., Andreassen, O., Christensen, P., Conaghan, P. G., … & Lohmander, L. S. (2013). EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Annals of the rheumatic diseases, 72(7), 1125-1135.
  3. National Institute for Health and Clinical Excellence. (2008). Osteoarthritis: national clinical guideline for care and management in adults. NICE and Royal College of Physician Guidelines on osteoarthritis.
  4. McAlindon, T. E., Bannuru, R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., … & Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and cartilage, 22(3), 363-388.
  5. Hochberg, M. C., Altman, R. D., April, K. T., Benkhalti, M., Guyatt, G., McGowan, J., … & Tugwell, P. (2012). American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis care & research, 64(4), 465-474.
  6. Waller, C., Hayes, D., Block, J. E., & London, N. J. (2011). Unload it: the key to the treatment of knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy, 19(11), 1823-1829.
  7. Duncan, R. C., Hay, E. M., Saklatvala, J., & Croft, P. R. (2006). Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology, 45(6), 757–760.doi:10.1093/rheumatology/kei270 Ledingham, J., Regan, M., Jones, A., & Doherty, M. (1993). Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital. Annals of the rheumatic diseases, 52(7), 520-526.
  8. Baker, K. R., Xu, L., Zhang, Y., Nevitt, M., Niu, J., Aliabadi, P., … & Felson, D. (2004). Quadriceps weakness and its relationship to tibiofemoral and patellofemoral knee osteoarthritis in Chinese: the Beijing osteoarthritis study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 50(6), 1815-1821.
  9. Mohammed, K.S. Al-Obaedi, O. Shah, M. (2018). Prevalence of Compartmental Osteoarthritis of the Knee in an Adult Patient Population: A Retrospective Observational Study. EC Orthopaedics
  10. Duncan, R., Peat, G., Thomas, E., Hay, E. M., & Croft, P. (2011). Incidence, progression and sequence of development of radiographic knee osteoarthritis in a symptomatic population. Annals of the Rheumatic Diseases, 70(11),
  11. Stefanik, J. J., Duncan, R., Felson, D. T., & Peat, G. (2017). Diagnostic Performance of Clinical Examination Measures and Pain Presentation to Identify Patellofemoral Joint Osteoarthritis. Arthritis Care & Research, 70(1), 157–161. doi:10.1002/acr.23238
  12. Heekin, R. D., & Fokin, A. A. (2014). Incidence of bicompartmental osteoarthritis in patients undergoing total and unicompartmental knee arthroplasty: is the time ripe for a less radical treatment?. The journal of knee surgery, 27(01), 077-082
  13. McGibbon, C. & Mohamed, A. Knee Load Reduction From an Energy Storing Mechanical Brace. Canadian Society for Biomechanics (2018)