A 55-year-old woman with osteoarthritis of both knees is started on knee bracing. Which type of brace is specifically designed for medial compartment OA to offload the affected compartment?

• A Hinged knee brace with varus alignment (shifting load to medial compartment)
• B Unloader (valgus offloading) knee brace applying a valgus force to the knee ✓
• C Patellar tracking brace for medial patellofemoral OA
• D Swedish knee cage for ligament stabilization

Explanation

Valgus offloading (unloader) knee braces are designed to apply a valgus moment to the tibiofemoral joint, shifting the mechanical axis laterally and reducing compressive load on the medial compartment in medial compartment OA. Controlled studies show reductions in pain and improved function in early-to-moderate medial compartment OA. A varus brace would further load the medial compartment (opposite effect). Lateral wedge insoles similarly shift load away from the medial compartment. Unloader braces are an evidence-based conservative option for medial OA before considering high tibial osteotomy or TKR.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.