KNEE ARTHRITIS - Changing the forces through the joint :
skiing with an unloader brace ?? - - Posted by plspencer (plspencer), 28 January 2004
After a very active and physical 10 years on a partially removed lateral meniscus I have now have grade III (and some small grade IV) osteoarthritis in the lateral compartment of my right knee. Medial side is "pristine" and all ligaments are fine. At 34 I have reluctantly decided to give up soccer and squash, but am not ready to give up tennis and skiing. Running gives me pain, although I can cycle and use cross-trainers okay. I've just come back from 3 days skiing, and although it could have been much worse, my knee was quite stiff, swollen and painful by the end of each day. (I am physically fit and ski very well, but fairly agressively).
My question is whether anything would help. I have read about unloader braces, but my surgeon said that the forces needed to keep the bones apart are too great for them to be effective. I have no problems/pain walking; only when I put excessive load through so I wouldn't need the brace for everyday wear.
Does anyone have any direct experience of them for active sports, or any other suggestions/solutions?
Thanks in hope! Patrick.
Posted by gimp (gimp), 30 January 2004
I tried an unloader for a while last summer. My OA is medial, but probably very similar to what you described. I am 31 and also decided it was time to give up on soccer and jogging. Those were both very tough decisions for me, but I decided that I'd rather be able to golf forever than play soccer for another year or two.
My dr. gave me an unloader to try during normal activities as well as light sports to see if it helped. I was pleased with the results, but was still not able to return to full activity. After a couple months, we agreed that my best bet was an osteotomy to permanently unload my medial compartment. I had been 4 degrees varus (bowed) prior to the surgery and am now 2 degrees valgus (knocked). My other leg is neutral. 4 months out now and am walking comfortably with very little day to day pain. I also notice a significant improvement in range of motion. Apparently my prior injuries had severly impacted my joint structure.
I would ask for the full x-rays from hip to feet to determine your bone alignment relative to your 'good' leg. The amount of correction required to unload your bad side may also indicate whether an unloader brace could help.
Good luck.
John
Posted by plspencer (plspencer), 2 February 2004
Thanks John, and glad to hear you're mending.
Sounds like a similar tough decision to mine - forsake strenuous and competitive activities for a future of golf, hiking and hopefully some recreational skiing.
I'm willing to try the unloaders as all the product descriptions on manufacturer's websites sound perfectly specified for my unicompartmental OA, but all makes look similar to me.
Some unloaders may be aimed at people who need to wear them all the time, and probably for low load activities like walking/gardening. I really need one for perhaps 10 days a year, for heavier load usage - with comfort etc less of an issue. I'm anxious to get the right make. Which one did your dr recommend for your activities?
Anyone else have any advice?
Many thanks again John, and hope you're on the golf course before too long!
Patrick.
Posted by soccerdoc (soccerdoc), 10 March 2004
Patrick,
I skied with a varus unloader and it was okay. I didn't enjoy bumps or the steeps as much as before my knee got bad. However I did use an unloader for a year and officiated 250 plus soccer matches ranging from youth premier th, college including D-1 and competitive sanctioned men's games (1st div open). When I had to start using the unloader for ADls I decided to have the HTO. I am 14 weeks post and have been skiing brace free and have resumed refereeing on a limited level.
I found the unloader a good assist for the time I used it.
Jim
Updated Sat Nov 21 2009
