Knee Brace

Aka: Knee Brace, External Knee Brace, Medial Unloader Knee Brace, Medial Unloading Brace, Patellar Stabilizing Brace, Patellar Tendon Strap, Infrapatellar Strap, Knee Immobilizer, Knee Immobilizing Splint

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II. Epidemiology

  1. Incidence of Knee Injury
    1. Annual: 6-22%
    2. Four years of play: 50%
    3. Occurs in 6-22% of players each year
  2. Common injuries
    1. Medial Collateral Ligament injury most common
    2. Terrible triad
      1. Medial Collateral Ligament (MCL)
      2. Anterior cruciate ligament (ACL)
      3. Medial meniscus

III. Preparations: Medial Unloader Knee Brace

  1. Indications
    1. Medial Knee Compartment Osteoarthritis
    2. Varus Knee Malalignment
  2. Description
    1. Hinged brace with support to unload medial knee compartment
  3. Efficacy
    1. Decreased need for knee arthroplasty over an 8 year period
    2. Lee (2017) BMJ Open Sports Exerc Med 2(1):e000195 [PubMed]
  4. Example
    1. https://www.amazon.com/dp/B07BY6P2W5?th=1

IV. Preparations: Patellar Stabilizing Brace

  1. Indications
    1. Patellofemoral Syndrome
    2. Patellar Instability
  2. Description
    1. Elastic sleeve with center cut-out for the Patella, and stabilizing bands
  3. Efficacy
    1. Marginal and inconsistent benefit when compared with Exercise alone
    2. Smith (2015) Cochrane Database Syst Rev (12):CD010513 [PubMed]
    3. Swart (2012) Br J Sports Med 46(8): 570-77 [PubMed]
    4. Warden (2008) Arthritis Rheum 59(1):73-83 [PubMed]

V. Preparations: Patellar Tendon Strap (Infrapatellar Strap)

  1. Indications
    1. Patellar Tendinopathy
  2. Description
    1. Narrow elastic strap is applied to mid-Patellar tendon
  3. Efficacy
    1. As effective as Patellar Taping for pain relief in Patellar Tendinopathy
    2. Rosen (2017) Knee 24(4): 761-7 [PubMed]
    3. de Vries (2016) Scan J Med Sci Sports 26(10): 1217-24 [PubMed]

VI. Preparations: Knee Immobilizer

  1. Indications
    1. Post-operative Splinting
    2. Quadriceps rupture
    3. Patellar Tendon Rupture
    4. Medial Collateral Ligament Rupture
    5. Patellar Fracture
    6. Tibial Plateau Fracture
  2. Description
    1. Rigid knee bracing that prevents flexion or extension of the knee
    2. Extends from upper thigh down to calf
    3. Held in position by straps

VII. Preparations: Prophylactic Knee Brace

  1. Design
    1. Titanium bar with added stiffness
  2. Advantages
    1. Allows normal Range of Motion
    2. Not dangerous to others
  3. Disadvantages
    1. Expensive
  4. Indications
    1. Prevent injury to Medial Collateral Ligament (MCL)
  5. Efficacy
    1. Unproven benefit

VIII. Preparations: Rehabilitation Knee Brace Design

  1. Hinges like Prophylactic brace
  2. Controls Range of Motion
    1. Has adjustable stops that limit ROM
  3. Does not migrate distally

IX. Preparations: Functional Knee Brace

  1. Indication
    1. Tries to control rotation in the ACL deficient knee
  2. Disadvantages
    1. Needs extensive rehabilitation program with brace use
    2. May not be able to return to cutting sports
  3. Efficacy
    1. Unproven benefit
    2. Off the shelf may be as effective as custom fit

X. References

  1. Paluska (2000) Am Fam Physician 61(2): 411-18 [PubMed]
  2. Sprouse (2018) Am Fam Physician 98(10): 570-6 [PubMed]

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