How does an unloader brace work for knee arthritis?

The idea behind it

In many people with knee arthritis, wear is worse on one side, most often the inner side in those who are slightly bow-legged. Each step concentrates load on that worn area. An unloader brace applies a gentle corrective force through a hinge and straps, opening that side a little and moving load towards the healthier side.

It does not regrow cartilage, but by reducing pressure on the painful area it can make walking easier.

Who it may suit

• Arthritis mainly on one side of the knee, confirmed on standing X-rays
• People who want to stay active and delay or avoid surgery
• Those not ready for, or not suitable for, an osteotomy or replacement
• Patients willing to wear a bulky brace during walking or activity

Downsides to know about

Unloader braces are larger than sleeves, can slip, rub the skin and feel hot, especially in Qatar's summer. Many people stop using them because of comfort. Evidence of benefit is mixed, and results vary between individuals. A trial period with good fitting helps decide whether it is worth continuing.

People with poor circulation, skin problems or arthritis in both sides of the knee may not benefit.

Alternatives and next steps

Strengthening exercise, weight management, walking aids and shoe changes are usually tried first. For suitable patients, a high tibial osteotomy realigns the leg permanently, and partial or total knee replacement is considered when arthritis is advanced. At Aman Hospital, Dr. Gelber reviews long-leg X-rays and discusses which option fits your knee and lifestyle.