PROGRESSION OF KNEE OA and how a DonJoy® OA brace can help
MALALIGNMENT
ABERRANT BIOMECHANICS
INCREASED BODY WEIGHT
INCREASED COMPARTMENT LOADING
DECREASED ACTIVITY
PAIN
DonJoy ® OA braces improve alignment 1,5,10,11,12
DonJoy OA braces reduce knee movements 1,4,5,10,12
DonJoy OA braces increase joint space 8,9
DonJoy OA braces relieve knee pain 1,2,3,9
DonJoy OA braces improve mobility and physical function 2,6
Fig. 3: The progression of knee OA
In the conservative treatment modalities, analgesia and non-steroidal anti-inflammatory (NSAIDs) drugs provide reductions in pain, increased quality of life and increased activity levels. However, they don’t address the underlying biomechanical causes and consequences of the OA disease process. There are reports of increased joint loading 39 and accelerated disease progression 18 probably due to increased pain free activity or walking speed. Off-loading braces allow for a more active lifestyle while protecting the knee joint from excessive loading. A DonJoy off-loading brace can help keep the patient in motion while protecting the knee joint from excessive loading 1 . Draganich L, Reider B, Rimington T, Piotrowski G, Mallik K, Nasson S. The effectiveness of self-adjustable custom and off-the-shelf bracing in the treatment of varus gonarthrosis. J Bone Joint Surg Am. 2006 Dec;88(12):2645-52. 2. Dries T, VAN DER Windt JW, Akkerman W, Kluijtmans M, Janssen RPA. Effects of a semi-rigid knee brace on mobility and pain in people with knee osteoarthritis. J Rehabil Med Clin Commun. 2022 Jul 5;5:2483. 3. Giori NJ. Load-shifting brace treatment for osteoarthritis of the knee: a minimum 2 1/2-year follow-up study. J Rehabil Res Dev. 2004 Mar;41(2):187-94. 4. Hart HF, Collins NJ, Ackland DC, Cowan SM, Hunt MA, Crossley KM. Immediate Effects of a Brace on Gait Biomechanics for Predominant Lateral Knee Osteoarthritis and Valgus Malalignment After Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2016 Apr;44(4):865-73. 5. Hart HF, Crossley KM, Collins NJ, Ackland DC. Bracing of the Reconstructed and Osteoarthritic Knee during High Dynamic Load Tasks. Med Sci Sports Exerc. 2017 Jun;49(6):1086-1096. 6. Khan M, Adili A, Winemaker M, Bhandari M. Management of osteoarthritis of the knee in younger patients. CMAJ. 2018 Jan 22;190(3):E72-E79. 7. Kwaees TA, Richards J, Rawlinson G, Charalambous CP, Chohan A. Can the use of proprioceptive knee braces have implications in the management of osteoarthritic knees: An exploratory study. Prosthet Orthot Int. 2019 Apr;43(2):140-147. 8. Nadaud MC, Komistek RD, Mahfouz MR, Dennis DA, Anderle MR. In Vivo Three-Dimensional Determination of the Effectiveness of the Osteoarthritis Knee Brace: A Multiple Brace Analysis. J Bone Joint Surg Am. 2005;87 Suppl 2:114-9. 9. Nagai K, Yang S, Fu FH, Anderst W. Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients. Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2354-2360. 10. Orishimo KF, Kremenic IJ, Lee SJ, McHugh MP, Nicholas SJ. Is valgus unloader bracing effective in normally aligned individuals: implications for post-surgical protocols following cartilage restoration procedures. Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2661-6. 11. Richards J, Jones R, Kim W. Biomechanical changes in the conservative treatment of medial compartment osteoarthritis of the knee using valgus bracing. ICRS 2006 12. The Comprehensive Textbook of Clinical Biomechanics, 2nd Edition. Elsevier 2018. ISBN 9780702054891.
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