Boyd W. Haynes III, MD
In this last article in the series, we’ll talk about the evidence for bracing, for what conditions bracing is often used and risks and complications inherent in getting a knee brace.
Evidence for the Use of Knee Bracing
You can do a Google search yourself and find plenty of data – but two studies I’ll highlight make the point well. The American Journal of Sports Medicine published a systematic review illustrating that functional knee braces significantly reduce the risk of subsequent ACL injuries in athletes. The Journal of Orthopaedic Research found that patients with medial compartment osteoarthritis who used unloader braces saw reduced pain and improved function.
If I asked any of my patients if they loved wearing their knee brace, I doubt any of them would raise their hand. However, most patients are generally positive when it comes to wearing their braces and believe they provide them with more stability, pain relief and improved mobility. I think the majority of post-surgical patients who wore knee braces during their rehabilitation period would say they were helpful in getting them to a good outcome more quickly and safely.
Knee braces are indicated for a variety of conditions, including but not limited to:
- Ligament Injuries can benefit from functional braces that provide stability and support during the healing process.
- anterior cruciate ligament (ACL)
- posterior cruciate ligament (PCL)
- medial collateral ligament (MCL)
- lateral collateral ligament (LCL)
- Meniscal tears – can be conservatively managed with bracing to help stabilize the knee and reduce pain. Also used to facilitate and postoperative recovery from meniscal repair surgery.
- Patellofemoral Pain Syndrome – patients with patellofemoral disorders can benefit from braces designed to align and support the patella for pain relief.
- Osteoarthritis -Unloader braces are specifically used to manage knee osteoarthritis by reducing stress on worn cartilage and bone, thus lessening pain and improving range of motion.
- Post-Surgical Rehabilitation knee braces are key in post-surgical protocols, providing protection and measured, progressive movement, aiding recovery
Risks and Complications
- Poor fit
- Bruising
- Rubbing/blisters/heat rash
- Pressure sores
- Nerve compression
- Uncomfortable – patient won’t wear
- Too tight/loose
- Wrong brace for condition/injury type
- Flexion/extension incorrectly set
- Overreliance can lead to muscle atrophy
- Stiffness and swelling
- DVTs (blood clots) from a constricting brace
As with any medical device, a brace should never be worn unless prescribed by a physician/medical professional who knows how one should be fitted and for what purpose. I’m not necessarily talking about those little neoprene sleeves to wear when you anticipate your knee to be sore from walking around Busch Gardens all day.
I do not recommend trying to “make-do” with a borrowed flexion/extension orthopaedic knee brace or a rigid brace that has not been fitted to you when you have a painful knee injury/condition. You could end up with blisters, a fall, or exacerbate your problem even further. Do yourself a favor and see a qualified musculoskeletal physician to have your knee examined and THEN get a brace specific to your knee, your type of injury or condition and your lifestyle and activity level. Wear it as prescribed and let your provider know immediately if there are any problems so that they can be addressed.