Unloader Knee Brace for Osteoarthritis

An X-ray showing osteoarthritis of the knee.
An X-ray showing osteoarthritis of the knee. SMC Images/Getty Images

About 27 million Americans have been diagnosed with osteoarthritis, a painful condition that usually affects the hands, knees, or hips.

Knee osteoarthritis, in particular, has increased in the United States due to obesity. In fact, according to the Centers for Disease Control and Prevention, half of all adults will develop knee osteoarthritis at some point in their life.

Knee braces are one way to provide stability, support, and pain relief for patients with knee osteoarthritis.

That said, many people do not know that there is more than one kind of knee brace, and one of the most effective knee braces, for the right person, is known as an unloader knee brace.

Let's learn more about how an unloader knee brace works and explore the scientific evidence surrounding its use.

Overview of an Unloader Knee Brace

The unloader knee brace is a custom-designed brace made of molded plastic, foam, and steel struts to limit side movement. It's designed to put three points of pressure on the thigh bone which forces the knee to bend away from the painful aspect of the knee.

Essentially, an unloader knee brace transfers or "unloads" stress or pressure from the inside to outside part of the knee or vice versa.

In other words, an unloader knee brace does exactly what its name suggests—it unloads stress from the affected joint. 

Most often, unloader knee braces are prescribed for those with medial compartment knee osteoarthritis, which is arthritis that affects the inner portion of the knee.

When you walk, if you have medial knee osteoarthritis, the instability in the knee can be obvious to someone who is watching you walk, as the knee actually wobbles towards the inside.

Even so, some designs of unloader knee braces can unload either the medial (inner) or lateral (outer) part of the knee, simply by adjusting the unloading hinge.

Scientific Evidence for Using a Knee Brace

Like any intervention or strategy for managing a chronic condition, you and your doctor will consider the scientific evidence or the studies to support its use.

The American Academy of Orthopaedic Surgeons (AAOS) assessed whether a valgus directing force knee brace (which means a medical compartment unloader) should be a formally recommended treatment for knee osteoarthritis. 

Experts examined three studies to see whether a brace (specifically for medical compartment knee osteoarthritis) improved knee pain, stiffness, self-reported functional capacity, and physical performance (for example, the number of stairs climbed in 30 seconds).

After analyzing the studies, experts from the AAOS deemed their recommendation for a medical compartment unloading knee brace to be inconclusive—in other words, the jury is still out on its true benefit.

What does this mean for you? This inconclusive recommendation implies that your doctor will exercise his or her own judgment when determining whether a brace is right for you.

It also means that your preference as a patient will be strongly considered when your doctor decides whether or not to suggest an unloader knee brace for your care.

Keep in mind, though, despite this inconclusive recommendation, the unloading knee brace is generally considered a highly cost-effective treatment that offers pain relief to many people.

Lastly, in addition to managing osteoarthritis, studies show that unloader knee braces can delay a person's need for knee replacement surgery and improve knee pain and stability associated with knee osteoarthritis after anterior cruciate ligament reconstruction (ACLR).

A Word From Verywell

On a final note, if your doctor suggests an unloader knee brace, here are a few tidbits to keep in mind.

  • Unloader knee braces can be bulky. You will want loose pant legs for it to look right.
  • Unloader knee braces can be pricey. Check with your insurance to be sure it will be covered.
  • Unloader knee braces are usually used along with your other osteoarthritis treatments, not instead of them. Keep taking medications or doing whatever else you and your doctor agreed upon.
  • There is not just one unloader knee brace. There are several designs of unloaders, so it's wise to have a professional help you choose what is right for you.

In the end, be sure to discuss with your personal doctor what type of knee brace would offer you the most benefit. The decision will depend on your specific problem and what limitation you are trying to overcome.

Sources:

American Academy of Orthopedic Surgeons. (2013). Treatment of Osteoarthritis of the Knee: Evidence-Based Guideline 2nd Edition.

Center for Disease Control and Prevention. (2010). A National Public Agenda for Osteoarthritis. 

Hart HF, Crossley KM, Ackland DC, Cowan SM, Collins NJ. Effects of an unloader knee brace on knee-related symptoms and function in people with post-traumatic knee osteoarthritis after anterior cruciate ligament reconstruction. Knee. 2016 Jan;23(1):85-90.

Ramset DK, Russel ME. Unloader braces for medial compartment knee osteoarthritis. Sports Health. 2009 Sep;1(5):416-26.

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