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Author Topic: Is Townsend Premier Reliever (PR1) a good choice for my new OA brace ?  (Read 9979 times)

Offline volleyballdiva

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Hi Everybody !  I知 really glad I found this forum.  I need to quickly get guidance on selecting an OA brace, as I have an appointment next week for a fitting for a Townsend.  My first question is, is there much difference between OA braces among the different manufacturers?  Like Townsend, Donjoy, Breg, Ossur ?   

Without going into too much detail, I知 looking for an offloader knee brace that will also serve as an ACL brace for sports.   This will be my first offloader.   My challenged leg is quite knock-kneed and I知 bone on bone laterally.  (Oddly, almost all of my pain is patellar-femoral, but I知 told part of this could be because my patella doesn稚 track properly, and also because it is 2/3 normal size since the middle third was removed to be used as my new ACL back in 1995.  That surgery, by the way, was poorly done, which is why this leg is messed up now.)   

My current brace (for sports) is a Townsend Rebel.    The Townsend rep has recommended a Premier Reliever (PR1). http://heritagemedical.typepad.com/heritage_medical/2009/08/townsend-design-premier-reliever1-pr1.html .  The rep who suggested this is not a 田ertified orthotist (how would I know if I needed that?)  but has been a Townsend rep for 16 years and fit me with my current brace.   But since he only deals with Townsend braces, I would imagine he is biased and not a good source for comparative info.   My doctor and PT don稚 have any answers on this.   Can I assume the manufacturers all use the same technology and materials?  If not, where can I get comparative info?   And any thoughts/conjecture on the likelihood that the brace would help with the pain under the patella and medial to it would be appreciated. 

So that's 3 questions:   

1.  Is the Townsend Premier Reliever PR1 as good as its competitors for a combo OA and ACL brace?  (Is there research on this?)
2.  How do you know if you need a "certified orthotist" to fit you for a brace?
3.  Can anyone help me understand how the brace can help with the patella (especially medial) pain ?

Thanks in advance

Offline bodywise

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Re: Is Townsend Premier Reliever (PR1) a good choice for my new OA brace ?
« Reply #1 on: November 14, 2012, 10:18:09 PM »
Hi, a bit late but I've only just read your message.

Answers...

1. This brace is NOT suitable for ACL as the straps are not configured to remove stress from the ligaments of the knee.  Plus this brace has a single hinge, and can be at risk of rotation, thus not providing enough stability.  I would only use it if I had mild to moderate OA only.

2. Ideally a qualified orthotist is the preferred choice, however, they can also be biased of he prefers on particular brace manufacturers.  Your Townsend rep would be very biased! Maybe seek a sports therapist who deals with brace fitting, and uses various manufactures or do the research yourself and self prescribe.

3. If you suffer from medial OA you will no doubt have issues with the medial side of your patella, as the bone compartments have collapsed or are closed.  An OA brace that loads from the lateral side should help open and relieve the pain.

My experience and choice for you would be DonJoy OA Nano.  It is dual hinged and is great for ACL as well!

Good luck!

Offline volleyballdiva

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Re: Is Townsend Premier Reliever (PR1) a good choice for my new OA brace ?
« Reply #2 on: November 15, 2012, 06:16:07 AM »
Hi Bodywise

Thanks for the response.  I appreciate your taking the time to write.

I have consulted the DME guy at the clinic where I saw the doc, and he has sent me to Kinetics Health Services.  Their guy measured me for a brace, and the Bledsoe-Z12-OA was suggested.   A good description is at
http://www.braceshop.com/productcart/pc/Bledsoe-Z12-OA-Arthritis-Knee-Brace-309p2030.htm

Unfortunately, the guy who came by to measure me for the brace was unable or unwilling to discuss braces with me, so I still don稚 know if this brace is best for my needs.  So I'm back here posting.

Here痴 a question: this brace is said to be for 杜ild to moderate OA.   If I am bone on bone, as the doc said, am I instead 都evere OA?   I don稚 want to under-correct and have consequences.
How does one know?   I don稚 mind wearing a big clunky brace if it is what I need.   The recommended Bledsoe is lightweight and therefore appealing. I just don稚 know how to figure out if I need more brace.  The doc was no help when I last saw him.  He seems to know nothing about braces.   Didn稚 know if I could play volleyball in an OA brace and encouraged me to just get my current ACL brace fixed up and go with it.  Yet he was the one who ordered and examined the x-ray and said the arthritis was worse and that I was now bone on bone.  Go figure.
As before, any thoughts/conjecture from any of you out there on the likelihood that this brace would help with the pain under the patella and medial to it would be appreciated.

Oh and if you read back through my post, you値l see that the bone on bone is lateral.  But as I said, I don稚 feel pain there.  Just some medial and mostly at the knee cap and below.  Some of that is because I had a patellar graft for the ACL, I imagine, and so have 2/3 of a patellar tendon left to handle the job of a whole intact tendon.

So, what are the chances this brace would help with the knee cap (and under and below) pain?
And is this enough brace for me? 

Thanks in advance for your thoughts.  BTW, another doc had included in his diagnosis, 菟atellar femoral syndrome.  Just another FYI.

This shouldn稚 be so hard.  Why don稚 the docs help more?  Is this common?

Offline Kaputt_Knee

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Re: Is Townsend Premier Reliever (PR1) a good choice for my new OA brace ?
« Reply #3 on: November 15, 2012, 07:38:48 AM »
Volleyballdiva,

You are not going to get impartial advice from anyone except perhaps a doctor or sports therapist who knows about ALL the braces available. And to be honest, they are as rare as hen's teeth.

I did my research contacting all the major brace companies and asked questions and kept asking them. I also talked to my doctor and therapists and asked what was needed then went back to the brace companies and asked more questions.

How do you know what Bodywise's qualifications are or if they are impartial? They say that the rep (naturally) will be biased to their products, yet their own post is also biased towards another company's products - so maybe they are a DonJoy rep, who knows.

I started my research because I was issued with a DonJoy Legend post operatively and knew that I would be wearing it for 2+ years for sport if I did not do my own research and see what was out there. It was big, clunky and hellishly uncomfortable and had to be constantly adjusted because of continuous slippage. But it did do its job well post-op.

I contacted the head of the sales divisions for all the major companies. Some just sent me brochures and lots of glossy sales photos of this or that sports personality wearing their product. Others took time to engage in a debate over what was suitable in their range for my needs. Townsend's Mike Huston was by far the most impartial and open with me. He discussed other makes as well as his own company's products, going so far to say that if I could not get a Townsend that he would recommend an Ossur brace to meet my needs. I was able to try different braces through my orthopaedic services provider (only the major players though like DonJoy and Bledsloe as well as a couple of locally produced ones). The German representative sent us a sample of the preferred brace which I showed my therapists and my surgeon. The design of the hinge is unusual because an awful lot of thought has gone into making sure that the movement is as near as possible identical to how your knee actually works in terms of flex and extension.

I opted to try a Rebell CI in the end, but could not get a custom-fit as they do not provide that service here in Germany. But after the specialist measured me, Townsend sent additional thigh and calf sections so that the length and width of the brace could be adjusted to as near as exact a fit as possible. I've now had that brace for 4 years and although I now only wear it for skiing it stills fits well, stills comfortably and does not move a millimetre during activity.

To be honest if you are "bone on bone" as well as ACL deficient, you really should not be playing volleyball except maybe occasionally "just for fun" until you get your knee sorted out. I played in National Division 1 in the UK and National Division 2 in France (way higher standard than in the UK) until I blew out my knee. Then I switched to coaching in order to stay in the game.

The key factors in getting the right brace for your condition is determination and pure hard-headed persistence. Perhaps concentrating on getting more opinions as to resolving your knee problems may be a good start. If you have been reliant on a brace since 1995, a lot of the patello-femoral imbalance could be a result of that horrible dilemma - damned if you do damned if you don't with wearing a brace.

BTW at no time did I research the price of my brace as my insurer was footing the bill. When I was finally fitted and happily taking part in my sports again my insurer rang me with a query to ask if there were any further costs to come. When I said no not as far as I knew, they were dumbfounded. It turned out that the Townsend was less than half the price of the usual braces they paid for!

Good luck with finding answers

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline volleyballdiva

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Re: Is Townsend Premier Reliever (PR1) a good choice for my new OA brace ?
« Reply #4 on: November 15, 2012, 06:02:35 PM »
Kaputknee (cool name, by the way),

Thank you so much for your comprehensive response. I so appreciate it ! I immediately called the company that took measurements and requested that the order for the brace be put on hold until I can get my questions answered. Customer Service said they would call the owner of their company to get him to call me. They don稚 know if the order is in yet. Also left a msg. w the rep who measured me. This company (selected by the Anderson Clinic, well respected here) has a choice of several manufacturers. Plus the owner has quite a lot of experience. I've asked that he call me, as have no idea whether he was involved in selecting the brace OR whether he had any info on my knee. ???

I have called my former PT and obtained an appt for this afternoon. I値l email him a link to the brace. He said a month or two ago that he didn稚 get involved with braces, but I can always beg.

I値l post later when I have more info.
Oh and I just play pick-up VB now. Stopped competing both locally and nationally years ago. Congratulations on your achievements in the volleyball world. And thank you for participating on this forum ! :)

Volleyballdiva

Offline Yan

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Some very intelligent questions - and answers on this thread!  I'm a few years late in responding but I am one of those lucky enough to have an orthotist who IS actually very familiar with every brand of OA brace I've ever asked him about (PERFORMANCE PROSTHETICS & ORTHOTICS).  Unfortunately for some ... he's located in Santa Monica, California.  I see you call them "offloaders" in the U.K. - we call them "unloaders" here in the states.  I have lengthy personal experience with Townsend, Donjoy, Ossur, Bledsoe, and Breg OA braces - which I've used for unicompartmental syndrome of the knee.  Here's what I want to add to the discussion, for whoever should come upon and read it.  If you have "moderate to severe" unicompartmental syndrome my orthotist and I would only recommend a dual hinge brace.  Breg has bought Bledsoe and their braces now show up on the Breg website.  The Z-12 is the lightest weight unloader I've used that is still stiff enough to do its job (the Donjoy Nano is a big disappointment).  But rather than having the angle of hinges altered to create unloading, it has an adjustable pad that simply puts more pressure on the undamaged side of the knee.  It unloads just fine - but the pressure of the pad can really irritate or even damage the skin on the side of the joint.  Not recommended unless you have really tough skin!  There's one small difference between the Donjoy braces and the Townsend braces that has turned out to be very significant to me.  The Donjoy brace requires you to step through the brace to put it on - as a result you cannot remove it without removing pants and shoe.  The Townsend just requires that you drop pants to below knee level to remove it because it is directly applied to the leg from the front and then straps on.  In my experience this difference does not affect unloading effectiveness at all.  Based on all my experience, the Townsend technology is the most advanced.  However, their Over The Counter braces are far better made than their custom braces (made from cast or scan).  I would not recommend Townsend CUSTOM braces at all but I find their OTC braces to be the best available so far.  The Rebel Reliever allows the wearer to adjust angular degree of unloading on BOTH sides.  This means that the same brace can be used for medial or lateral unicompartmental syndrome by simply adjusting the hinges.  One can also adjust the hinges to matched settings and use it as a sports ligament brace.  Pretty clever, huh?  Townsend's parent company is THUASNE which I believe is the international company - and the name on the website.  I don't know that much about the Townsend Premier OA brace but I would compare it to the Townsend Rebel Reliever to evaluate it.  The Thuasne/Townsend website only notes the Rebel Reliever for non-custom OA brace and I can recommend it wholeheartedly.  In the U.S. the Townsend Design Company is located in Bakersfield, California.  They are the only company I know that has a licensed, very scrupulous, very helpful ORTHOTIST on hand to answer questions about their braces.  Their U.S. number (in the Pacific Time Zone) is 800.432.3466.