Knee Braces

CHAPTER 193 Knee Braces

The knee joint is the largest joint in the body, and traumatic, overuse, and degenerative knee injuries are common. Strength, flexibility, and technique modification have traditionally been essential components in the treatment of knee pain. Improved surgical techniques, arthroscopic advances, and smaller incisions have also enhanced therapy for knee disorders over the last few decades. More recently, knee braces have been used in an attempt to prevent or treat several knee conditions.

Knee braces typically fall into one of several broad categories:

Despite their popularity, the appropriate indications and true benefits of many knee braces have not been clearly defined or validated by rigorous research. In addition, brace manufacturers market several different knee braces to address conditions that may be nonspecific and diverse. As a result, confusion often exists regarding when and if knee braces should be used for the prevention or treatment of various knee abnormalities. At this point, it can be said that some knee braces may minimize knee injuries, but the efficacy of most braces has not been confirmed by well-controlled studies. In general, most individuals using knee braces express subjective symptomatic improvements that exceed objective findings. Clinicians must assess the costs and potential risks of knee braces when deciding to use them for individuals. Although knee braces appear relatively safe when used appropriately, they should be used only in conjunction with appropriate education, muscular rehabilitation, technique enhancement, and activity modification.


Prophylactic Knee Braces

Prophylactic knee braces are used to prevent injury to the MCL or LCL during contact sports or to provide stability during recovery after an MCL or LCL sprain (Fig. 193-1). Although the routine use prophylactic knee braces for collateral ligament injury prevention may be controversial, they do have a more well-defined role during MCL or LCL rehabilitation. Prophylactic knee braces are available as custom or off-the-shelf (prefabricated) models (Figs. 193-2 and 193-3). They have either a single lateral hinged support or bilateral supports with polycentric hinges that are connected by fabric and closures. Cost is greater for custom models, which appear to have greater efficacy during both knee flexion and extension. Although high-level athletes may profit from the weight distribution and fit characteristics of a custom brace, a prefabricated brace is sufficient for most individuals. At-risk athletes, such as football linemen, may particularly benefit from wearing well-fitting prophylactic knee braces on both knees during practices and games. However, it should be noted that prophylactic knee brace use may have a negative impact on an athlete’s speed, agility, fatigability, and endurance.

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May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Knee Braces

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