Custom-Made Knee Brace Better Than Off-the-Shelf BraceKnee bracing is an acceptable solution to off-loading stress on the joint in an effort to control pain and stiffness. Bracing allows the patient to control the position of the knee in order to reduce symptoms. Braces can either be ready to wear off-the-shelf or custom made for each individual patient.
In this study, short-term results are compared between these two types of knee braces. Ten adult patients with a diagnosis of varus gonarthrosis were included.
Varus gonarthrosis means there's been arthritic wear and tear of the medial (inner side) of the knee joint. The patient has medial knee pain and stiffness. The X-ray shows narrowing of the medial joint space.
Both braces have thigh and leg straps to hold the brace in place. Upright bars on either side frame the leg. Hinge joints on both sides allow full knee motion. The wearer uses a special key to make adjustments of the angle. The custom-fit brace is made based on specific measurements of each individual patient. The off-the-shelf brace is more of a generic one-size-fits-all.
All 10 patients wore both braces an average of eight to nine hours each day. Half the group wore the custom-made brace everyday for four or five weeks. The other half wore the off-the-self brace for the same time period. Then each group took a two-week break before switching to the other brace.
Comparisons were made based on pain, stiffness, and function. A special 3-D computerized system was used to analyze gait and stair-stepping activities. Knee angles were calculated from full-length X-rays taken of the hip, knee, and ankle.
Results showed that the custom brace was more effective in pain relief, reduction of stiffness, and improved function. Speed of walking was no different between the two braces but knee angles were better during stair climbing with the custom brace.
The authors suggest use of a patient-adjustable, valgus-producing unloader brace for patients with varus gonarthrosis. Allowing patients to adjust the custom brace to get the best pain relief is a good idea. Both off-the-shelf and custom-fit bracing have positive benefits. The custom-fit brace is more effective overall.
Louis Draganich, PhD, et al. The Effectiveness of Self-Adjustable Custom and Off-the-Shelf Bracing in the Treatment of Varus Gonarthrosis. December 2006. Vol. 88-A. No. 12. Pp. 2645-2652.
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