Are Knee Braces Orthotics?

July 3, 2024

Demystifying the question, "are knee braces orthotics?" Explore their efficacy, uses, and future research.

Understanding Knee Braces and Orthotics

When it comes to managing knee pain or stabilizing the knee joint, knee braces and orthotics are often mentioned interchangeably. However, it's important to understand the distinction between these two tools to answer the question, "are knee braces orthotics?"

Defining Orthotic

The term "orthotic" has two distinct uses in the medical field. As an adjective, it was first used in 1955, but its usage as a noun, which is more common in current parlance, was defined in 1981. In a broad sense, an orthotic refers to a device that provides support, aligns, prevents, or corrects deformities or improves the function of movable parts of the body. Orthotics can be custom-made or bought ready-made from stores.

Orthotics are made and fitted by healthcare providers known as orthotists. These professionals have the skills to adapt purchased braces or create custom-designed ones to cater to the specific needs of individuals. Some examples include the AFO brace (ankle-foot orthosis) and KAFO brace (knee-ankle-foot orthosis, or long leg brace).

Types of Knee Braces

Knee braces, on the other hand, are specialized supports worn on a painful or injured knee. They can also be used to prevent injuries during contact sports. These braces are typically made from a combination of materials such as metal, foam, plastic, elastic material, and straps. They come in various sizes, colors, and designs.

The American Academy of Family Physicians identifies four main types of knee braces:

Prophylactic braces: These are worn on healthy knees to protect them during contact sports.
Functional braces: These are designed to support knees that have been injured.
Rehabilitative braces: These limit harmful knee movement while a knee injury is healing.
Patellofemoral braces: These help the kneecap move smoothly over the knee joint.

Each type of knee brace has a specific purpose and is designed to meet unique needs. In essence, while knee braces are a type of orthotic, not all orthotics are knee braces. This distinction is crucial to understand when determining the best approach for managing knee-related issues.

Effectiveness of Knee Braces

In the realm of orthotics, knee braces are often utilized to provide support, stability, and pain relief for various knee conditions. However, the effectiveness of knee braces varies among individuals and depends greatly on the type of brace and the specific knee condition it is being used to address. There are three primary types of knee braces: prophylactic, functional, and patellofemoral.

Prophylactic Knee Braces

Prophylactic knee braces are designed to protect the knees from injuries during contact sports like football. Despite their widespread use, there is currently insufficient evidence to suggest that these braces are effective in reducing the incidence or severity of ligamentous knee injuries. As such, the regular use of a prophylactic knee brace at any level of athletic competition is not generally recommended [4].

Type of Brace	Purpose	Effectiveness
Prophylactic Knee Braces	Protect knees during contact sports	Limited evidence of efficacy

Functional Knee Braces

Functional knee braces are used to support knees that have already been injured. These braces offer some control of external knee rotation and anteroposterior joint translation. They are considered useful adjuncts to muscular rehabilitation, particularly for graft protection following Anterior Cruciate Ligament (ACL) reconstruction. However, like prophylactic braces, their effectiveness varies among individuals.

Type of Brace	Purpose	Effectiveness
Functional Knee Braces	Support injured knees	Varies among individuals

Patellofemoral Knee Braces

Patellofemoral knee braces are designed to treat anterior knee disorders. These braces offer moderate subjective improvement without significant disadvantages. They work by altering the forces going through the knee and redistributing the weight the knee carries. This can reduce the amount of pain and damage caused by certain knee conditions.

Type of Brace	Purpose	Effectiveness
Patellofemoral Knee Braces	Treat anterior knee disorders	Moderate subjective improvement

It's important to note that different knee problems require different knee braces. Therefore, it's essential to consult a healthcare provider to determine the most suitable type of knee brace for your specific condition. Furthermore, knee braces should be used as directed during sports activities and should be regularly inspected for wear and tear. Proper care, including regular cleaning and checking the placement of the brace during activities, is crucial for the brace's effectiveness.

Considerations for Knee Braces

When considering the use of knee braces, it's important to weigh the benefits and limitations, as well as consider the differences between custom and off-the-shelf options.

Benefits and Limitations

Knee braces are commonly used to provide support and stability, alleviate pain, and prevent injuries. However, the effectiveness of knee braces remains a topic of debate. Manufacturers often claim their benefits, but scientific studies have not reached a consensus. Some medical professionals express concern that knee braces might increase the risk of knee injuries in athletes, while others believe they can be helpful.

In terms of cost, knee braces can be expensive, with prices reaching hundreds of dollars. While some insurance plans may cover their cost, it's worth noting that the most expensive brace may not necessarily be the most effective. This highlights the need for consultation with healthcare providers before making a purchase.

Custom vs. Off-the-Shelf Braces

When choosing a knee brace, one major decision involves selecting between custom-made or off-the-shelf options.

Off-the-shelf knee braces come in pre-made sizes ranging from small to large, and occasionally extra-large. These are more accessible and cost-effective, catering to a broad range of individuals [6].

On the other hand, custom-made knee braces are created through various methods, such as traditional techniques involving casts and measurements, or more advanced approaches like using a smartphone app. The primary aim is to achieve a well-fitted brace that offers maximum support and comfort.

Both off-the-shelf and custom-made knee braces offer distinct advantages, making it challenging to determine which one is superior. They cater to different needs and situations, suggesting that comparing the two may not be entirely fair.

In conclusion, when considering are knee braces orthotics? The decision should be made based on individual needs, preferences, and advice from healthcare professionals. Whether one opts for an off-the-shelf or custom brace, the focus should be on finding a solution that provides the necessary support, comfort, and protection.

Orthotists and Prosthetists

When discussing the question, "are knee braces orthotics?", it's essential to understand the roles of orthotists and prosthetists. These healthcare experts specialize in designing, fabricating, and fitting orthoses and prostheses to support, align, prevent, or correct deformities, and to improve the function of body parts.

Roles and Responsibilities

An orthotist is a healthcare provider who makes and fits braces and splints (orthoses), which provide added support for body parts weakened by injury, disease, or nerve, muscle, or bone disorders. The orthotist's role includes adapting purchased braces or creating custom-designed braces, such as the AFO brace (ankle-foot orthosis) and the KAFO brace (knee-ankle-foot orthosis, or long leg brace).

Furthermore, orthotists specialize in evaluating, designing, fabricating, and fitting orthoses. They work closely with patients to assess their needs, develop treatment plans, and create custom orthoses that meet their specific requirements. Orthotists may also provide education and training on the use and care of orthoses to ensure optimal outcomes for patients.

On the other hand, a prosthetist is a healthcare provider who makes and fits artificial limbs (prostheses) for individuals with disabilities. This could include artificial legs and arms for those who have undergone amputations due to diseases, disorders, or injury. Prosthetists have specialized education and training in graduate programs or internships and may work in various settings like hospitals, inpatient rehab centers, outpatient rehab centers, private practice, and industrial health centers.

Prosthetists specialize in the design, fabrication, and fitting of prostheses, and work closely with patients to assess their needs, develop treatment plans, and create custom prostheses that restore function and mobility. They also provide ongoing care and adjustments to ensure the optimal fit and function of the prostheses, as well as provide education and training on their use and maintenance.

Custom Design Process

In both roles, the process of creating custom orthoses or prostheses involves a series of steps. First, the orthotist or prosthetist conducts a comprehensive assessment of the patient's physical condition and needs. This involves taking precise measurements and possibly creating a plaster cast of the affected body part to ensure an accurate fit.

Next, the orthotist or prosthetist uses these measurements to design the orthosis or prosthesis. This can be done using traditional hand-drawing methods or with computer-aided design (CAD) software. The design is then transformed into a physical device using various materials such as plastic, metal, or composite materials.

Once the device is fabricated, the orthotist or prosthetist fits it to the patient and makes any necessary adjustments to ensure a comfortable and functional fit. They also provide the patient with instructions on how to use and care for the device, and schedule follow-up appointments to monitor the patient's progress and make any needed adjustments.

The custom design process ensures that each orthosis or prosthesis is tailored to the individual patient's needs, resulting in a higher level of comfort and functionality compared to off-the-shelf devices. This personalized approach is one of the reasons why orthotists and prosthetists play such a crucial role in healthcare.

Knee Braces for Osteoarthritis

Osteoarthritis is one of the common conditions that could potentially benefit from the use of knee braces and orthotics. However, understanding the effectiveness of these treatments can be a complex task. In this segment, we will examine how knee braces can aid in pain reduction and potentially slow down disease progression.

Pain Reduction

The primary purpose of knee braces and foot/ankle orthoses for osteoarthritis of the knee is to reduce pain and improve physical function. However, the evidence supporting this claim is not conclusive. Some studies suggest that bracing does not significantly impact pain, stiffness, function, and quality of life in patients suffering from medial compartment knee osteoarthritis [9].

In contrast, another study showed a lower visual analogue scale (VAS) pain score in the group wearing laterally wedged insoles compared to the group with no insoles after nine months [9].

Treatment	Effect on Pain Score
Bracing	No Significant Impact
Laterally Wedged Insoles	Lower VAS Pain Score

Disease Progression

As for the effect of knee braces on the progression of osteoarthritis, the evidence is also not definitive. Some research suggests no notable effect on function scores and health-related quality of life scores after 12 months in a brace versus no treatment comparison [9].

Similarly, there was little evidence of an effect on pain scores, stiffness scores, function scores, and health-related quality of life scores in a comparison between laterally wedged and neutral insoles.

Treatment	Effect on Disease Progression
Bracing	No Notable Impact
Laterally Wedged Insoles	No Notable Impact

The application and effectiveness of knee braces as orthotics in managing osteoarthritis pain and progression is a topic that requires further exploration and research. While some studies indicate potential benefits, others suggest negligible effects. As such, a dialogue with healthcare providers is essential to determine the best course of action for individual patients.

Controversy and Future Research

The use of knee braces and orthotics has been a topic of ongoing debate within the medical community. This controversy revolves around the efficacy of these devices and the best approach to their use.

Debates on Efficacy

Scientific studies have not completely agreed on the effectiveness of knee braces. While companies manufacturing these devices claim they work well, the consensus within the medical community is less clear. In general, functional and rehabilitative braces are seen as the most effective. However, the effectiveness of braces varies among individuals. There are concerns that knee braces may potentially increase the number of knee injuries in athletes [3].

Additionally, the debate continues on whether custom made knee braces are better than off-the-shelf knee braces and vice versa. Professionals sometimes recommend off-the-shelf knee braces for less severe injuries due to their cost-friendliness. Both off-the-shelf and custom-made knee braces offer distinct advantages, making it challenging to determine which one is superior, as they cater to different needs and situations.

Consultation with Healthcare Providers

Given these ongoing debates, experts recommend consulting with healthcare providers to determine the best approach to using knee braces. Different knee problems require different knee braces, with recommendations varying from post-surgery braces to braces for support instead of surgery for specific conditions. It is essential to consult a doctor to determine the type of knee brace needed [3].

Knee braces should be used as directed by a doctor during sports activities and should be inspected regularly for wear and tear. Proper care, including regular cleaning and checking the placement of the brace during activities, is important for the brace's effectiveness.

Consultation with a healthcare provider is strongly recommended, as the scientific research has not provided a clear answer on the effectiveness of knee braces. Some doctors recommend wearing a brace for knee pain, while others do not.

Researchers are working to understand the true efficacy of knee braces and determine the optimal situations for their use. It is crucial for individuals to consult with their doctors to establish the necessity of a knee brace in their specific case [5].