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Does an unloader brace reduce knee loading in normally aligned knees?

Jay R Ebert¹, Karen Hambly, Brendan Joss

¹School of Sport Science, Exercise and Health, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Western Australia, jay.ebert@uwa.edu.au.

Clinical Orthopaedics and Related Research

|September 26, 2013

Summary

Unloader knee braces showed inconsistent effects on knee joint loading and muscle activation in individuals with normal knee alignment. This study questions their efficacy for patients undergoing articular cartilage repair.

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Area of Science:

Orthopedics
Biomechanics
Sports Medicine

Background:

Unloading knee braces are commonly used post-tibiofemoral articular cartilage repair.
Limited experimental data exists on their efficacy in patients with normal knee alignment.

Purpose of the Study:

To investigate the impact of varus and valgus adjustments of an unloader knee brace.
To assess effects on tibiofemoral joint loading and knee muscle activation in normally aligned knees.

Main Methods:

Gait analysis of 20 healthy participants under braced (varus, valgus) and non-braced conditions.
Measurement of spatiotemporal variables, knee adduction moments, and muscle activation during stance.
Calculation of a directed cocontraction ratio to assess muscle activation patterns.

Main Results:

No statistically significant differences in knee kinetics or muscle activity were found between braced and non-braced conditions.
Both varus and valgus bracing increased the relative activation of muscles with lateral moment arms compared to no brace.
Conflicting outcomes observed: varus bracing increased knee adduction moments but showed lateral muscle activation, while valgus bracing showed lateral muscle activation but increased knee adduction moments.

Conclusions:

The study revealed inconsistencies in knee kinetics and muscle activation strategies with unloader bracing in normally aligned knees.
Observed effect sizes suggest potential, warranting further investigation in larger studies.
Findings question the current efficacy of unloader bracing for patients with normal knee alignment, such as those post-articular cartilage repair.