Knee braces - unloading
Osteoarthritis of the Knee
When most people talk about the arthritis in their knees, they are referring to a type of arthritis called osteoarthritis.
Osteoarthritis is caused by wear and tear inside your knee joints.
- Cartilage, the firm, rubbery tissue that cushions all of your bones and joints, lets the bones glide over one another.
- If the cartilage wears away, the bones rub together, causing pain, swelling, and stiffness.
- Bony spurs or growths form and the ligaments and muscles around the knee become weaker. Over time, your whole knee becomes stiffer and stiffer.
Unloading Braces for Knee Arthritis
In some people, arthritis may affect mostly the inside of the knee. This may be because the inside of the knee often bears more of a person's weight than the outside of the knee.
A special brace called an "unloading brace" may help take some of the pressure off the worn part of your knee when you are standing.
An unloading brace does not cure your arthritis. But it may help relieve symptoms such as knee pain or buckling when you move around. People who want to delay having knee replacement surgery may want to try using unloading braces. Unfortunately, these unloader braces are only effective when one side, either the inside or the outside part, of the knee is worn out. If the knee has generalized arthritis, the brace would not work well.
There are two types of unloading braces:
- An orthotist can make a custom fitted unloading brace. You will need a prescription from your health care provider. These braces often cost over $1,000 and insurance may not pay for them.
- Unloading braces may be bought in different sizes at a medical device store without a prescription. These braces cost a few hundred dollars. However, they may not fit as well and be as effective as custom braces.
It is not clear how effective unloading braces are. Some people say they have fewer symptoms when they use them. Some medical studies have tested these braces but this research has not proven whether or not unloading braces provide help for people with knee arthritis. However, using a brace does not cause harm and it can be used for early arthritis or while waiting for replacements.
Hui C, Thompson SR, Giffin JR. Knee arthritis. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 104.
Shultz ST. Orthoses for knee dysfunction. In: Chui KK, Jorge M, Yen S-C, Lusardi MM, eds. Orthotics and Prosthetics in Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 11.
Van Thiel GS, Rasheed A, Bach BR. Knee bracing for athletic injuries. In: Scott WN, ed. Insall & Scott Surgery of the Knee. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 58.
Last reviewed on: 8/12/2023
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.