SUPPORTIVE DEVICES

Supportive devices that may help to reduce the pain from osteoarthritis of the knee include canes, orthotics (shoe inserts), and knee braces.

Canes

The use of a cane reduces the amount of weight placed on the knee joint while walking thereby decreasing knee pain. The cane should be held in the hand opposite to the affected knee. If the pain is in the left knee, the cane should be held in the right hand.

Knee Braces

There are two common types of braces which are used for the osteoarthritis of the knee:

Elastic or Neoprene Supportive Braces

These braces are readily available at most drugstores. Some people find they feel better with added elastic support around the knee. There have not been many studies that show that these braces actually make a difference to slow or stop the progression of osteoarthritis of the knee, however they are relatively inexpensive and safe to try. These types of braces are usually worn by people who feel the need for added support during sports or daily activities. Elastic, neoprene or similar braces should not be used by people who have a history of blood clots in their legs (deep venous thrombosis) or recurrent swelling in the ankles. Their use may worsen these conditions.

Unloader Brace

An unloader brace may be effective in reducing the symptoms of osteoarthritis of the knee when the osteoarthritis affects only one compartment of the knee (see knee anatomy). The medial compartment is on the inner side of the knee. The lateral compartment is on the outer side of the knee. Doctors are able to tell which compartment of the knee is affected based on the symptoms, physical findings, x-ray findings, and/or the results of arthroscopy.

When one compartment is affected by osteoarthritis, the affected compartment tends to collapse. The goal of the unloader brace is to unload the weight from the collapsed compartment. If the medial compartment is collapsed, a brace is used to put more force on the healthy lateral compartment and less on the arthritic, medial compartment.

An unloader knee brace is generally more effective than a simple sleeve. It has been shown in numerous studies to reduce pain and decrease the need for medication to control symptoms of osteoarthritis of the knee. This is important for individuals who are unable to take anti-inflammatory pills because of their side effects. Furthermore, use of an unloader brace may delay or even prevent the need for surgery down the road. The majority of patients who use the unloader brace experience some pain relief and improvement in function. This allows them to participate in some of the activities they would otherwise be unable to participate in.

It should be noted that unloader braces are not for everyone. They are considerably more expensive than elastic or neoprene sleeves. Some people find them to be too bulky and cumbersome. It is important to discuss this and other bracing options with a doctor, a physiotherapist or a knowledgeable brace fitter. Many people are allowed to "test drive" a brace for a day to see if it is a good treatment option.

Orthotics (Shoe Inserts)

For people with poor knee alignment (bowlegged or knock kneed) shoe orthotics may be a good treatment option. A shoe orthotic may help change the alignment of the knee in order to reduce stress on the joint. There are various types of shoe orthotics available. They can be custom made or purchased at a pharmacy or shoe store. Doctors or physiotherapists who deal with osteoarthritis of the knee will be able to tell you if a supportive device or a shoe orthotic is likely improve symptoms.

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