Category: Donjoy

Early Mechanical Control After Acute ACL Rupture: What Bracing Teaches Us About Healing and Stability

Posted on | by Matthew Blackwell

Anterior cruciate ligament (ACL) injuries are among the most significant musculoskeletal injuries encountered in clinical practice, affecting active individuals and athletes across a wide range of sports and activity levels. The immediate post-injury period has traditionally been viewed as a preparatory phase before surgical or non-surgical treatment begins. However, emerging evidence suggests that the decisions made in the first days and weeks after injury – including whether and how to brace the knee – may have a meaningful influence on both healing biology and joint stability.

This article examines two recent clinical studies that shed new light on early mechanical control as an active component of acute ACL management, with implications for clinicians across both non-surgical and surgical care pathways.

Why Early Mechanical Control Matters in Acute ACL Injury

Early management is a well‑established component of acute anterior cruciate ligament (ACL) injury care. Emerging evidence now places increased focus on the mechanical environment created in the immediate post‑injury phase, suggesting that early mechanical control of the knee may influence both biological healing processes and functional stability.

Recent clinical studies examining early bracing strategies highlight that temporary immobilization after ACL rupture may be associated with favorable outcomes through different but complementary mechanisms, supporting ligament healing pathways identifiable on MRI in selected patients, and reducing high‑grade rotational instability associated with injury to anterolateral knee structures. Together, these findings invite a closer examination of early bracing as an active component of acute ACL injury management rather than a purely interim measure.

MRI-Guided Healing Pathways: The Cross-Bracing Protocol

A prospective case series1 investigated outcomes in 80 consecutive patients who presented within 4 weeks of acute ACL rupture and were managed non‑surgically using the Cross‑Bracing Protocol (CBP). The protocol involved knee immobilization at 90° of flexion in a 4-point knee ligament brace with ROM control for 4 weeks, followed by progressive increases in range of motion until brace removal at 12 weeks, alongside physiotherapist‑supervised, goal‑oriented rehabilitation. MRI was performed at 3 and 6 months, with ACL healing graded using the ACL Osteoarthritis Score (ACLOAS).

At 3 months, 90% (72/80) of patients demonstrated MRI evidence of ACL continuity. Healing was graded as ACLOAS grade 1 (thickened or taut ligament) in 50%, grade 2 (thinned or elongated ligament) in 40%, and grade 3 (absent ligament or discontinuity) in 10% of patients. Patients with ACLOAS grade 1 reported higher Lysholm and ACL‑QOL scores, demonstrated lower passive knee laxity, and had higher rates of return to pre‑injury sport at 12 months compared with those graded ACLOAS 2–3. ACL re‑injury occurred in 14% of patients, primarily during high‑force or high‑velocity activities.

Refining Patient Selection: ACL-ARCH MRI Criteria

Building on experience managing over 1080 active individuals and athletes with CBP, a subsequent publication2 proposed the ACL Acute Rupture Characteristics for Healing (ACL‑ARCH) MRI criteria to better characterize acute ACL rupture severity in relation to potential non‑surgical healing. The authors describe four key MRI features relevant to healing potential: integrity of femoral and tibial attachment, displacement of ACL tissue outside the intercondylar notch, gap distance between torn ends, and retraction of ACL ends into rounded stumps (“involution”).

Within the first 80 patients treated with CBP, partial femoral avulsion and displacement of ACL tissue outside the intercondylar notch were more frequently observed in patients with thinned, elongated, or absent healing on 3‑month MRI. Larger gap distances (≥7 mm) were also more common in patients with poorer healing outcomes.

The authors recommend minimum 1.5T MRI (3T preferred) and the use of double‑oblique sequences to optimize visualization of ACL fibers when assessing these features.

Early Post-Traumatic Bracing and Rotational Knee Stability

A multicenter retrospective consecutive study3 examined 168 patients who underwent ACL reconstruction and compared outcomes between those who received early post‑traumatic knee immobilization and those who did not. Of the total cohort, 132 patients received a knee brace (hinged or non‑hinged), while 36 patients received no immobilization. The mean time from trauma to bracing was 0.8 days, and the mean duration of immobilization was 23.9 days. Patients were allowed full weight-bearing after immobilization.

The primary outcome was the severity of pivot shift, assessed intra‑operatively under general anesthesia. A grade 3 pivot shift was observed in 27% (44/168) of patients overall and was significantly more frequent in patients without a brace compared with those who received early bracing (50% vs 19.7%, p = 0.0012). Both hinged and non‑hinged braces were associated with a lower risk of grade 3 pivot shift, with odds ratios of 0.221 and 0.232, respectively. Immobilization lasting ≤3 weeks was associated with a higher risk of grade 3 pivot shift compared with immobilization for >3 weeks.

The authors conclude that early post-injury bracing was associated with a lower incidence of high-grade rotational instability before ACL reconstruction. They suggest that systematic immobilization after knee trauma could be advocated based on these findings.

Two Studies, One Shared Message

Although the two studies differ in design, patient populations, and primary outcomes, they converge on a shared principle: the early mechanical environment of the injured knee matters. The CBP and ACL-ARCH publications describe how early immobilization combined with MRI assessment can provide insight into ACL healing characteristics and rupture severity, while the multicenter surgical cohort study demonstrates that early bracing is associated with reduced high-grade rotational instability at the time of reconstruction. Together, these findings highlight early bracing as a potentially influential factor across different acute ACL care pathways.

Key Take-Home Messages

  • Early mechanical control of the knee is a management variable in the acute phase after after ACL rupture
  • Structured early bracing has been associated with:
    • MRI‑observed ACL healing characteristics
    • Reduced incidence of high‑grade pivot shift before ACL reconstruction
  • Healing potential and rotational stability represent distinct but complementary outcomes
  • Early bracing may be relevant across both non‑surgical and surgical ACL care pathways

Supporting ACL Care with DonJoy® Bracing Solutions

The evidence discussed in this article points to the importance of providing appropriate mechanical control at every stage of ACL injury management – from the immediate post-injury period through to return to sport. Enovis™ offers two DonJoy® bracing solutions designed to support clinicians across this continuum of care.

DonJoy® X-ROM™ Post-Op Knee Brace: Early Post-Traumatic and Post-Operative Immobilization

The DonJoy X-ROM™ Post-Op Knee Brace is designed to aid immobilization and provide protected range of motion (ROM) following ACL, PCL, LCL, and MCL surgeries, as well as meniscal repairs. Its updated hinge design allows precise ROM control in 10-degree increments, from -10° to 90° extension and -10° to 120° flexion, with a quick-lock feature for easy setting at a specific angle. Four independently telescoping sliders with push-button control enable rapid, precise fitting across a wide range of patient anatomies. The brace is universal-fit, accommodating patients from 150 cm to 195 cm, and bendable hinge bars allow additional varus or valgus contouring where needed.

For clinicians considering early bracing as part of acute ACL management – whether in the context of the Cross-Bracing Protocol or early post-traumatic immobilization prior to surgery – the X-ROM offers a structured, adjustable platform to deliver controlled immobilization and progressive range of motion as rehabilitation advances.

DonJoy X-ROM post-op knee brace

DonJoy® Armor FourcePoint™: Functional Bracing and Return to Sport

The DonJoy Armor FourcePoint™ delivers strong, lightweight protection for moderate to severe ligament instabilities – appropriate for active users and extreme‑sport athletes – combining a moldable aircraft‑grade aluminum frame with the patented Four‑Points‑of‑Leverage™ System and the FourcePoint™ hinge, which dampens knee extension in the high‑risk zone to support stability, reduce re‑injury risk, and ensure a secure, comfortable fit across a wide size range.

A steel-reinforced hinge plate and T6061 aluminum frame deliver robust, lightweight durability suited to contact and extreme sports including football, skiing, snowboarding, and motocross.

For patients who demonstrate favorable healing characteristics on MRI or who are returning to high-demand sport following ACL reconstruction, the Armor FourcePoint provides an evidence-informed, off-the-shelf option to support ongoing knee stability and reduce re-injury risk. Available in seven sizes and two calf lengths, it accommodates bilateral use without impeding performance.

DonJoy Armor FourcePoint knee ligament brace

Armor is also available in a version that swaps the FourcePoint hinge for a standard polycentric hinge. By adding flexion stops of (0°), 45°, 60°, 75°, or 90°, or extension stops of 0°, 10°, 20°, 30°, or 40°, this allows incremental flexion-extension ROM control to support different phases of rehabilitation.

For more information on Enovis™ products, visit our website or contact your local Enovis representative.

References

  1. Filbay SR et al. Healing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical management with the Cross Bracing Protocol. Br J Sports Med. 2023 Dec;57(23):1490-1497.
  2. Filbay SR et al. A new way of grading severity of ACL rupture on acute MRI to consider potential for non-surgical healing with the Cross Bracing Protocol: ACL Acute Rupture Characteristics for Healing (ACL-ARCH) MRI criteria. J Sci Med Sport. 2026 Feb;29(2):145-148.
  3. Murgier J et al. Does an early post traumatic knee brace reduce the incidence of knee rotational instability? Arch Orthop Trauma Surg. 2024 Mar;144(3):1161-1169.

Walker Boots vs Plaster Casts: Cost-Effectiveness and Clinical Outcomes

Posted on | by Matthew Blackwell

For decades, plaster casts have been the default choice for immobilizing lower-limb injuries such as Achilles tendon ruptures and ankle fractures. However, growing clinical evidence suggests that functional walker boots offer a cost-effective alternative without compromising patient outcomes or safety.

So what does the latest research actually tell us? And how should this influence treatment decisions in modern orthopedic care?

Rethinking Immobilization: Why Cost-Effectiveness Matters

Healthcare systems are under increasing pressure to deliver high-quality outcomes while controlling costs. Immobilization strategies play a significant role in this equation, not just in terms of device cost, but also:

  • Time and resources required for application and removal
  • Follow-up appointments and unplanned hospital visits
  • Need for informal care and support
  • Speed of functional recovery and return to work

Multiple studies now indicate that walker boots consistently perform well across these areas, particularly when early weight-bearing protocols are used.

Achilles Tendon Rupture: Comparable Outcomes, Lower Overall Costs

One of the most robust datasets comes from the UKSTAR trial by Costa et al.1, a large multicenter randomized controlled study involving 527 patients across 39 NHS hospitals. The trial compared:

  • Traditional plaster casting (8 weeks, delayed weight bearing)
  • Functional walker boot (8 weeks, immediate weight bearing)

Key findings:

  • Total health and social care costs were slightly lower in the walker group (by approximately £103 per patient), although the difference was not statistically significant
  • No difference in functional outcome at 9 months, measured using the Achilles Tendon Total Rupture Score (ATRS)
  • No difference in re-rupture rates, confirming comparable safety profiles

In other words, functional bracing delivered equivalent clinical results at a lower or comparable cost, while enabling earlier mobilization.

Importantly, clinicians concluded that early weight-bearing in a walker boot can be considered a safe and cost-effective alternative to plaster casting.

Why Walker Boots May Support Better Recovery

The cost-utility advantage of walker boots is not purely financial, it is closely linked to how patients recover.

Evidence suggests improved functional recovery may be related to:

  • Greater comfort and convenience for patients2
  • Compatibility with early weight-bearing protocols1,3,4
  • Ability to remove the boot for controlled mobilization exercises1,5,6
  • Reduced reliance on informal carers7

These factors can translate into faster return to normal activity and work1,4,7, which has major societal and economic implications beyond direct healthcare costs.

Ankle Fractures: Strong Evidence Across Operative and Non-Operative Care

The evidence is equally compelling for ankle fractures. A UK multicenter randomized trial evaluated cast immobilization versus walker boots in 669 patients across 20 NHS trauma units.

Clinical outcomes:

  • No significant difference in functional outcomes at 4 months or 2 years8,9
  • Functional outcomes measured using the Olerud-Molander Ankle Score (OMAS) were equivalent8,9
  • Complication rates were similar between cast and walker groups8,9

Economic outcomes:

  • Cost-utility analysis showed that, from an NHS perspective, removable braces were cost-effective under commonly accepted willingness-to-pay thresholds10

The authors concluded that a removable walker boot is as effective and safe as a plaster cast, for both operative and non-operative ankle fracture management, and remains so in the long term.

Post-Operative Ankle Fractures: The Case for Early Weight Bearing

Recent studies have added another important dimension: timing of weight bearing.

Two major UK trials provide valuable insights:

1. Ankle Recovery Trial (ART)

  • Compared walker boots versus casts after ankle fracture surgery
  • Found the total treatment cost per patient was £676 lower in the walker group
  • Analysis included not only device cost, but also informal care and productivity losses

2. Weight-bearing in Ankle Fracture (WAX) Trial

  • Compared early vs delayed weight bearing post-operatively
  • Early weight bearing was associated with £722 lower mean societal costs, largely due to reduced work absence

Taken together, these findings suggest that early weight bearing in a walker boot may offer substantial cost savings compared to delayed weight bearing in a cast, without compromising safety or outcomes4,7.

What This Means for Clinical Practice

Across Achilles tendon rupture and ankle fracture management – both conservative and post-operative – the evidence consistently shows that walker boots:

  • Are at least as effective as plaster casts
  • Offer comparable safety profiles
  • Support earlier mobilization and weight bearing
  • Can deliver meaningful cost savings, especially when societal costs are considered

For clinicians and healthcare systems alike, this supports a shift toward functional immobilization strategies where clinically appropriate.

Conclusion: Walker Boots are Evidence-Based, Patient-Centered, Cost-Effective

Modern functional walkers allow clinicians to align clinical outcomes, patient experience, and economic efficiency. As the evidence base continues to grow, walker boots are increasingly positioned not as an alternative, but as a first-line option for many lower-limb injuries.

As always, individual patient factors and clinical judgement remain paramount, but the data clearly supports giving functional bracing serious consideration in contemporary orthopedic care.

DonJoy® Nextep Xcel™: a New Cost-Effective Walker Range from Enovis™

DonJoy Nextep Xcel walker boot range

Healthcare professionals need dependable orthopedic solutions that are designed to deliver consistent patient outcomes while remaining practical. The new DonJoy® Nextep Xcel™ range meets these needs through a family of full-shell walker boots for post-operative and post-trauma foot and ankle care.

By integrating established technology with streamlined design, Nextep Xcel offers a comprehensive approach to patient mobility management. The range provides the clinical performance clinicians expect while supporting efficiency within practices.

The Nextep Xcel range represents a balanced approach to orthopedic care, delivering the functionality patients need and the reliability clinicians value.

For more information on Enovis’s portfolio of orthopedic walker boots, visit our website or contact your local Enovis representative.

References

  1. Costa ML et al. UKSTAR trial collaborators. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. Lancet. 2020 Feb 8;395(10222):441-448.
  2. Hampton MJ et al. Functional Walker Boots are Preferred to Synthetic Casts by Patients and Carers in the Management of Pediatric Stable Ankle Injuries. J Pediatr Orthop. 2024 Feb 1;44(2):99-105.
  3. Ghaddaf AA et al. Early versus late weightbearing in conservative management of acute achilles tendon rupture: A systematic review and meta-analysis of randomized controlled trials. Injury. 2022 Apr;53(4):1543-1551.
  4. Bretherton CP et al. WAX Investigators. Early versus delayed weight-bearing following operatively treated ankle fracture (WAX): a non-inferiority, multicentre, randomised controlled trial. Lancet. 2024 Jun 29;403(10446):2787-2797.
  5. Egol KA et al. Functional outcome of surgery for fractures of the ankle. A prospective, randomised comparison of management in a cast or a functional brace. J Bone Joint Surg Br. 2000 Mar;82(2):246-9.
  6. Barile F et al. To cast or not to cast? Postoperative care of ankle fractures: a meta-analysis of randomized controlled trials. Musculoskelet Surg. 2024 Dec;108(4):383-393.
  7. Baji P et al. Use of removable support boot versus cast for early mobilisation after ankle fracture surgery: cost-effectiveness analysis and qualitative findings of the Ankle Recovery Trial (ART). BMJ Open. 2024 Jan 11;14(1):e073542.
  8. Kearney R et al. AIR trial collaborators. Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial. BMJ. 2021 Jul 5;374:n1506.
  9. Nwankwo H et al. Cost-utility analysis of cast compared to removable brace in the management of adult patients with ankle fractures. Bone Jt Open. 2022 Jun;3(6):455-462.
  10. Haque A et al. the AIR Trial collaborators. Use of cast immobilization versus removable brace in adults with an ankle fracture: two-year follow-up of a multicentre randomized controlled trial. Bone Joint J. 2023 Mar 15;105-B(4):382-388.

How Therapeutic Shoes Help Protect Feet with Diabetic Neuropathy

Posted on | by Matthew Blackwell

For people living with diabetes, caring for the feet is essential. High blood glucose over time can lead to diabetic neuropathy – nerve damage that reduces sensation in the feet. When the feet lose feeling, everyday pressure, friction, or minor injuries may go unnoticed. Over time, these stresses can develop into diabetic foot ulcers, affecting mobility, independence, and overall quality of life.

That is why choosing the right footwear is so important.

Therapeutic shoes are designed to help protect feet affected by diabetes-related nerve damage by supporting healthy movement, reducing stress on vulnerable tissue, and lowering the risk of skin breakdown. Research shows that specialized footwear can significantly reduce pressure and tissue strain on the foot – two key factors linked to ulcer development – making it a vital part of diabetic foot care for many patients.

In this article, we explore how therapeutic footwear helps safeguard the feet in people with diabetic neuropathy, and how Enovis™ is supporting safer, more confident mobility with the new DonJoy® therapeutic shoe collection.

Why Diabetic Neuropathy Increases Foot Ulcer Risk

Diabetic neuropathy affects the nerves that supply sensation to the feet. Without the ability to feel pain or irritation, patients may not recognise when harmful pressure, heat, or friction is occurring.

This can lead to:

  • Loss of protective sensation
  • Increased risk of skin breakdown
  • Higher likelihood of ulcer formation
  • Reduced balance and gait stability

Because these risks often develop gradually, preventative foot care – including protective footwear – is a cornerstone of long-term diabetic health management.

The Role of Therapeutic Footwear in Diabetic Foot Protection

How footwear reduces pressure and tissue strain

When walking, weight and ground-reaction forces concentrate under the forefoot, especially beneath the metatarsal heads. In diabetic neuropathy, these forces can silently damage tissue.

A clinical biomechanics study investigating people with diabetes, peripheral neuropathy, and previous plantar ulcers found that therapeutic footwear significantly reduced both plantar pressure and soft-tissue strain – mechanical factors that contribute to ulcer formation1.

Compared to barefoot loading, therapeutic shoes and supportive inserts progressively lowered harmful forces beneath the foot:

  • Pressure and strain were highest barefoot
  • Both reduced significantly with therapeutic shoes
  • Additional reductions occurred with total-contact inserts and metatarsal pads

Why reducing pressure matters for patients with nerve damage

Lower pressure and controlled strain help limit stress on vulnerable tissue, supporting:

  • Protection against ulcer recurrence
  • Safer daily mobility
  • Improved comfort in weight-bearing activities
  • Confidence in returning to everyday routines

In neuropathic feet, pressure relief isn’t just comfort, it’s injury prevention.

Clinical Evidence: How Supportive Footwear Helps Protect the Diabetic Foot

The study demonstrated clear biomechanical benefits from appropriate footwear for people with diabetic neuropathy:

  • Pressure at the second metatarsal head decreased across all therapeutic footwear conditions
  • Soft-tissue strain also reduced proportionally
  • The most protective configuration (shoe + insert + metatarsal pad) produced the greatest benefit1

This evidence reinforces clinical practice guidance: properly designed therapeutic shoes support pressure redistribution, help protect insensate tissue, and reduce ulcer risk2,3.

Key Features of Effective Therapeutic Shoes for Diabetic Feet

High-quality therapeutic footwear typically includes:

  • Wide toe box to accommodate deformities and swelling
  • Smooth interior with minimal seams to reduce friction
  • Cushioned insole to help distribute pressure
  • Stable, anti-slip outsole for safer walking
  • Breathable, lightweight materials to support long periods of wear
  • Easy fastening systems (zip or hook-and-loop) to support patients with reduced dexterity

These design features work together to help maintain mobility and protect vulnerable feet in everyday environments.

Introducing the New DonJoy® Therapeutic Shoes Collection

Foot health is fundamental to movement, and movement is essential for life. That’s why DonJoy has expanded its trusted orthopedic offering to include a new range of therapeutic footwear designed for patients with diabetes, vascular conditions, post-operative needs, and other foot-health challenges.

The four new models bring therapeutic protection together with everyday style:

Stanley – versatile tennis-style shoe

Lightweight, ventilated upper, easy zip closure, cushioned insole, anti-slip outsole

Newton – casual, breathable sneaker

Perforated upper, generous toe box, zip closure, supportive cushioned interior

Nina – elegant therapeutic loafer for women

Slip-on, elasticated opening, cushioned insole, discreet therapeutic profile

Gaby – soft indoor therapeutic slipper

Hook-and-loop fastening, seamless padded interior, lightweight design

Together, these designs offer options that protect vulnerable feet without compromising appearance or comfort.

Supporting Safer Steps for People with Diabetes

Protecting the feet is essential for anyone living with diabetic neuropathy. Therapeutic footwear provides a clinically supported way to reduce harmful pressure, lower ulcer risk, and support daily mobility and independence.

With the new DonJoy therapeutic shoe collection, patients can move confidently with footwear engineered for comfort, protection, and style – wherever life takes them.

To learn more or request information, visit enovis-medtech.eu or speak with your local Enovis representative.

References

  1. Lott DJ, Hastings MK, Commean PK, Smith KE, Mueller MJ. Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot. Clin Biomech (Bristol). 2007;22(3):352-359.
  2. Schaper NC, van Netten JJ, Apelqvist J, et al. Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36 Suppl 1:e3266.
  3. Bus SA, Sacco ICN, Monteiro-Soares M, et al. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev. 2024;40(3):e3651.

How Shoulder Braces Support Post-Operative Shoulder Recovery

Posted on | by Matthew Blackwell

Shoulder surgery represents a significant step toward resolving chronic pain or repairing damage, but the recovery process demands careful attention and appropriate support. Shoulder braces, such as the DonJoy PSI Plus, play an essential role in this recovery journey, providing stability and protection while healing progresses.

The Purpose of Shoulder Braces After Surgery

Following shoulder procedures such as rotator cuff repairs, labral reconstructions, or joint replacements, shoulder braces serve several critical recovery functions:

  • Immobilizing the joint to protect surgical repairs
  • Limiting potentially harmful movements
  • Reducing stress on healing tissues
  • Offering external support during rehabilitation phases

Types of Shoulder Braces for Post-Surgical Recovery

Different surgical procedures require specific types of support:

Immobilization Slings

These devices hold the arm close to the body, preventing movement during the initial healing phase. They typically feature:

  • Adjustable straps for proper positioning
  • Cushioning to prevent skin irritation
  • Simple design for ease of application

Example: DonJoy PSI Plus

Abduction Slings

For procedures requiring the arm to be held away from the body:

  • Maintains the shoulder in a specific abducted position
  • Includes a pillow or wedge to establish proper joint spacing
  • Helps reduce tension on certain repaired structures

Example: UltraSling PRO

Functional Braces

As recovery progresses, functional braces allow:

  • Controlled range of motion within safe parameters
  • Adjustable settings to gradually increase mobility
  • Support during rehabilitation exercises

Example: UltraSling Quadrant

Progression of Shoulder Brace Usage Throughout Recovery

The timeline for shoulder brace usage typically follows this pattern:

  • Stage 1: Strict immobilization with limited removal for hygiene or prescribed exercises
  • Stage 2: Transition to braces allowing controlled movement, often worn during physical therapy and daily activities
  • Stage 3: Decreased dependence on bracing with continued use during challenging activities or exercise
  • Stage 4: Occasional use for protection during high-risk activities or as needed for comfort

Benefits of Proper Brace Usage

Research indicates that appropriate bracing contributes to recovery by:

  • Promoting proper healing alignment of tissues1
  • Reducing the risk of re-injury during vulnerable healing phases2
  • Decreasing pain through stabilization3
  • Building patient confidence during rehabilitation4

Wearing a Shoulder Brace

For maximum benefit from a shoulder brace, patients should:

  • Follow their surgeon’s specific instructions regarding wear time
  • Ensure proper fit—too loose provides inadequate support, too tight may impair circulation
  • Inspect their skin regularly for irritation or pressure points
  • Maintain cleanliness of the brace according to manufacturer guidelines
  • Report any issues with fit or function to their healthcare provider

A New Brace for Post-Op Shoulder Recovery: DonJoy PSI Plus

The DonJoy PSI Plus shoulder immobilizer represents a thoughtful approach to post-operative shoulder support, addressing both clinical and patient needs.

Designed for Adaptability

The PSI Plus features a bilateral design that converts between left and right arm use by simply repositioning the arm and shoulder strap. This versatility:

  • Simplifies inventory management for healthcare facilities
  • Ensures appropriate support regardless of which shoulder requires immobilization

Patient-Centered Features

Several design elements focus on improving the patient experience:

  • A quick-access hand pocket supports the forearm in internal rotation
  • Lightweight, open construction promotes air circulation to reduce heat buildup
  • Enhanced comfort during extended wear periods supports treatment compliance
DonJoy PSI Plus shoulder immobilizer

Clinical Efficiency

Healthcare providers benefit from:

  • Intuitive strap configuration that reduces application time
  • Design that minimizes the risk of incorrect positioning
  • The ability to perform examinations without removing the entire sling

Practical Functionality

The PSI Plus includes an adjustable shoulder strap with a quick-release mechanism, enabling single-handed removal and attachment. This feature proves particularly valuable for patients managing daily activities during recovery.

For more information on DonJoy PSI Plus, contact your local Enovis representative here.

References

  1. Hurley ET, Fried JW, Alaia MJ, Strauss EJ, Jazrawi LM, Matache BA. Immobilisation in external rotation after first-time traumatic anterior shoulder instability reduces recurrent instability: a meta-analysis. J ISAKOS. 2021 Jan;6(1):22-27.
  2. Grubhofer F, Ernstbrunner L, Gerber C, Hochreiter B, Schwihla I, Wieser K, Bouaicha S. Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair. JB JS Open Access. 2022 May 5;7(2):e21.00148.
  3. Conti M, Garofalo R, Castagna A. Does a brace influence clinical outcomes after arthroscopic rotator cuff repair? Musculoskelet Surg. 2015 Sep;99 Suppl 1:S31-5.
  4. Chu JC, Kane EJ, Arnold BL, Gansneder BM. The Effect of a Neoprene Shoulder Stabilizer on Active Joint-Reposition Sense in Subjects With Stable and Unstable Shoulders. J Athl Train. 2002 Jun;37(2):141-145.

Cold Therapy and Compression for Post-Operative Knee Recovery: What the Latest Evidence Says

Posted on | by Matthew Blackwell

Effective post-operative recovery following knee surgeries represents a significant challenge for healthcare providers as well as their patients. Procedures such as total knee arthroplasty (TKA), anterior cruciate ligament (ACL) reconstruction, and arthroscopic interventions require comprehensive recovery protocols to ensure optimal outcomes. Among the various supportive modalities available, cold therapy and compression have emerged as approaches worthy of consideration within orthopedic recovery protocols. 

This article aims to summarize the current clinical evidence surrounding cold therapy and compression techniques in post-operative knee recovery and provide insights for healthcare professionals seeking to enhance patient care following these common orthopedic procedures. 

The Clinical Challenge: Pain, Swelling, and Rehabilitation 

Post-operative knee patients commonly face several challenges that can impede their recovery trajectory. Inflammation at the surgical site often leads to significant pain, which may limit mobility and delay rehabilitation milestones. Additionally, many patients develop a reliance on pain medications, particularly opioids, which carries risks of dependence and side effects. 

These complications underscore the importance of implementing effective, low-risk adjunctive therapies that can support recovery, potentially reduce medication requirements, and improve overall patient outcomes. As healthcare providers continue to refine recovery protocols, evidence-based approaches to managing these challenges become increasingly valuable. 

What the Research Shows: A Summary of Key Studies 

Studies supporting cold therapy after Total Knee Arthroplasty (TKA) 

Several studies support the application of cold therapy following total knee arthroplasty. 

In a 2015 study by Bech et al.1, it was found that although there was no additional benefit of using the DonJoy Iceman over ice bags for pain reduction, TKA patients using the device were significantly more satisfied, used the device more consistently, day and night, and were more likely to recommend this method of cooling.

In 2006, Kullenberg et al.2 demonstrated that the Aircast Cryo/Cuff achieved better pain control, ROM improvement, and shorter hospital stays amongst 86 patients undergoing TKA than with epidural analgesia, NSAIDs, and opioids. 

Holmström et al. (2005)3 found that Aircast Cryo/Cuff is a viable alternative for pain management following TKA, as it was shown to be as effective as epidural anesthesia for pain reduction, while also being well tolerated, non-invasive, and risk-free. 

In a meta-analysis of studies on cold therapy for pain in total knee replacement patients, Yildiz et al. (2024)4 found that the application of cryotherapy was important in relieving patients’ pain, reducing it by a factor of 2.9.

Studies supporting cold therapy after ACL reconstruction

There is good evidence to support the use of cold therapy following anterior cruciate ligament (ACL) reconstruction. 

In their 2022 study, Yonetani et al.5 found that film dressing enhanced the effect of the Aircast Cryo/Cuff and Ice bags with respect to pain control immediately after ACL reconstruction surgery compared with traditional gauze dressing with elastic wrap. 

Hart et al. (2014)6 demonstrated that after ACL reconstruction, patients with arthrogenic muscle inhibition AMI who received cryotherapy immediately before performing rehabilitation exercises experienced greater strength gains than those who performed cryotherapy or exercises alone. 

Raynor et al.’s 2005 study7 showed that cryotherapy reduces post-operative pain significantly and being fairly inexpensive, easy to use, and satisfactory to patients, is therefore beneficial in the post-operative management of knee surgery. 

Furthermore, Kotsifaki et al.’s 2023 study8 resulted in the publication of new Aspetar guidelines that recommended the use of cold and compression therapy, along with neuromuscular electronic stimulation (NMES) in the early rehab protocol of ACL reconstruction.

Studies supporting cold therapy after knee arthroscopy 

According to these studies, knee arthroscopy is another procedure that can benefit from post-operative cold therapy.

In 2011, Stalman et al.9 found a significant decrease of knee temperature and associated pain and inflammation marker PGE2 with post-op Knee Cryo/Cuff application.

Martin et al.’s 2001 study10 showed a significant decrease of intraarticular temperature of the knee after arthroscopy with Aircast Cryo/Cuff application.

And Song et al.’s 201611 meta-analysis found that cold and compression is more beneficial for reduction of pain and swelling at the early post-operative period for knee surgery than cold alone. 

Conclusion

The growing body of evidence surrounding cold therapy and compression for post-operative knee recovery provides healthcare professionals with valuable insights for enhancing patient care. Across multiple procedure types, research consistently demonstrates benefits in pain management and potentially decreased reliance on pharmacological interventions. 

As a low-risk, cost-effective adjunct to established recovery protocols, cold therapy merits consideration within comprehensive rehabilitation approaches. This data may offer clinicians additional perspectives to consider when evaluating their current post-operative management approaches, with cold therapy and compression representing potential options within comprehensive rehabilitation frameworks. 

By implementing evidence-based approaches to post-operative care, healthcare providers can continue to enhance recovery experiences and outcomes for knee surgery patients, supporting their journey toward restored function and improved quality of life. 

Healthcare professionals interested in Enovis’s portfolio of cold therapy products can contact their local sales representative here.

References

  1. Bech M, Moorhen J, Cho M, Lavergne MR, Stothers K, Hoens AM. Device or ice: the effect of consistent cooling using a device compared with intermittent cooling using an ice bag after total knee arthroplasty. Physiother Can. 2015 Winter;67(1):48-55. 
  2. Kullenberg B, Ylipää S, Söderlund K, Resch S. Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. J Arthroplasty. 2006 Dec;21(8):1175-9. 
  3. Holmström A, Härdin BC. Cryo/Cuff compared to epidural anesthesia after knee unicompartmental arthroplasty: a prospective, randomized and controlled study of 60 patients with a 6-week follow-up. J Arthroplasty. 2005 Apr;20(3):316-21. 
  4. Yildiz T, Topcu O, Avcu C. The effect of cryotherapy on pain in patients with total knee replacement surgery: a meta-analysis. Acta Orthop Belg. 2024 Mar;90(1):123-129. 
  5. Yonetani Y, Kurokawa M, Amano H, Kusano M, Kanamoto T, Tanaka Y, Horibe S. The Wound Dressing Influenced Effectiveness of Cryotherapy After Anterior Cruciate Ligament Reconstruction: Case-Control Study Comparing Gauze Versus Film Dressing. Arthrosc Sports Med Rehabil. 2022 Mar 8;4(3):e965-e968. 
  6. Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction. J Athl Train. 2014 Nov-Dec;49(6):733-9. 
  7. Raynor MC, Pietrobon R, Guller U, Higgins LD. Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg. 2005 Apr;18(2):123-9. 
  8. Kotsifaki R, Korakakis V, King E, Barbosa O, Maree D, Pantouveris M, Bjerregaard A, Luomajoki J, Wilhelmsen J, Whiteley R. Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. Br J Sports Med. 2023 May;57(9):500-514. 
  9. Stålman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L. Temperature-sensitive release of prostaglandin E₂ and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am. 2011 Nov 2;93(21):1961-8. 
  10. Martin SS, Spindler KP, Tarter JW, Detwiler K, Petersen HA. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. Am J Sports Med. 2001 May-Jun;29(3):288-91. 
  11. Song M, Sun X, Tian X, Zhang X, Shi T, Sun R, Dai W. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis. Springerplus. 2016 Jul 13;5(1):1074. 

Enovis™ Unveils Unified Brand Identity

Posted on | by Matthew Blackwell

For decades, healthcare professionals have trusted products from DonJoy®, Chattanooga®, and Aircast® to deliver exceptional patient outcomes. These iconic brands, part of the Enovis™ family, have shaped orthopedic care and rehabilitation across the globe. Today, Enovis—a worldwide leader in medical technology solutions—announces a strategic visual transformation that unites these trusted names under a cohesive brand identity while preserving their individual legacies of innovation.

The Enovis Family: A Legacy of Innovative Brands

Enovis encompasses approximately a dozen specialized product brands within its comprehensive portfolio. Each brand brings distinctive expertise to the continuum of care, from prevention and rehabilitation to surgical intervention. Let’s explore the remarkable journeys of three cornerstone brands:

DonJoy® – Protecting Knees (and More) Since the 1970s

DonJoy has become virtually synonymous with knee bracing excellence. This cornerstone Enovis brand has manufactured and supplied braces for knee ligament protection since the late 1970s, utilizing patented technology specifically designed to reduce anterior cruciate ligament (ACL) strain1,2.

The Garage That Changed Orthopedics

In 1978, Philadelphia Eagles’ offensive line captain Mark Nordquist and lawyer Ken Reed founded a small company in a Carlsbad, California garage. They named their venture DonJoy after their wives, Donna and Joy—a personal touch that reflected their commitment to improving patients’ lives.

DonJoy initially focused on developing knee braces, and by the late 1990s, it was generating approximately $100 million in annual revenues through an expanding range of orthopedic products. Following a series of strategic acquisitions and mergers, the company evolved into DJO and later, Enovis. Throughout these transformations, the DonJoy name has endured for almost half a century, proudly displayed on products worn by millions worldwide.

Flagship Product: Defiance® PRO

The Defiance® PRO represents the culmination of decades of research in knee stability engineering. This custom-fit functional knee brace features aircraft-grade aluminum and proprietary hinge technology that mirrors natural knee movement while providing crucial support for ACL, PCL, MCL, and LCL injuries. Professional athletes and weekend warriors alike rely on its lightweight yet robust design for confidence during activity.

Aircast® – Over Half a Century in Service of Medical Professionals

For more than 50 years, medical professionals worldwide have depended on Aircast for technological breakthroughs in patient care.

Rooted in sound scientific methods, each Aircast product is developed using the concept of “functional management,” setting progressive standards of care for lower limb fractures, ankle sprains, and other injuries with patented technology and graduated pneumatic compression.

Aircast was founded in 1972 by U.S. inventor Glenn Johnson Jr. after he created the eponymous pneumatic ankle brace system. The innovative air cell technology provides targeted compression and stabilization while allowing appropriate movement—a revolutionary approach to ankle injury management. Among Johnson’s other inventions was the VenaFlow™ system, a DVT-prevention device used in hospitals worldwide.

Flagship Product: AirSelect™ Walker

The AirSelect™ Walker exemplifies Aircast’s commitment to functional recovery. Its SoftStrike technology absorbs shock and reduces heel loading, while integrated air cells deliver customized compression. The intuitive pump system allows patients to adjust pressure levels independently, promoting compliance and improving outcomes. Clinical studies have demonstrated faster recovery times compared to traditional immobilization methods for appropriate indications.3,4

Chattanooga® – Supporting Physiotherapists Since 1947

Founded in Chattanooga, Tennessee, by local athletic trainer Lee Jensen and his business partner Jack Walker, the Chattanooga Group began as Chattanooga Pharmacal Company in 1947.

From Local Startup to Global Leader

The company initially created hot and cold therapy products for the physiotherapy market before expanding its innovation focus. A significant breakthrough came with the development of the Intelect line, which brought portable ultrasound and electrotherapy devices into private clinics and transformed treatment accessibility.

By the early 2000s, Chattanooga had established itself as the world’s largest manufacturer of rehabilitation equipment, contributing to improved treatment outcomes in hospitals, clinics, and home settings worldwide. After nearly 80 years, the Chattanooga brand continues to be associated with technological advancements in treating musculoskeletal, neurological, and soft tissue disorders.

Flagship Product: LightForce® Laser

The LightForce® laser therapy system represents a significant advancement in non-invasive pain management. Using specific wavelengths of light to penetrate tissue and stimulate cellular metabolism, this photobiomodulation therapy helps reduce inflammation and relieve pain.5 Clinicians appreciate its intuitive interface and customizable treatment protocols that address a wide range of conditions from tendinopathies to post-surgical recovery.

Introducing the Updated Enovis Product Brands

As a family of brands under the banner of Enovis, DonJoy, Aircast, Chattanooga, and their sister brands now share a cohesive visual identity that clearly communicates their relationship while honoring their individual histories.

Enovis product brand logo update

The refreshed type treatment applied to the product brand logos achieves a unified aesthetic while creating a clear hierarchy between the corporate brand and its product brands. The updated design maintains recognizable elements from each brand’s heritage while bringing them into alignment with Enovis’s forward-looking vision.

For healthcare professionals who have relied on these trusted brands throughout their careers, this unified identity signals not an ending but a strengthening—a commitment to continued excellence and innovation under the Enovis banner for decades to come.

Healthcare professionals interested in learning more about Enovis products can contact their local Enovis representative.

References

  1. Fleming BC et al. The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees. Am J Sports Med 2000;28(6):815-24.
  2. Lin CF, Liu H, Garrett WE, Yu B. Effects of a knee extension constraint brace on selected lower extremity motion patterns during a stop-jump task. J Appl Biomech. 2008 May;24(2):158-65.
  3. Shahid MK, Punwar S, Boulind C, Bannister G. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal: a comparative cohort study. Foot Ankle Int. 2013 Jan;34(1):75-9.
  4. Haworth L, Booth N, Chohan A, Chapman G, Richards J. How does orthotic walker boot design influence lower limb and trunk function during gait? Prosthet Orthot Int. 2024 Mar. E-Pub ahead of publication.
  5. Chatterjee P, Srivastava AK, Kumar DA, Chakrawarty A, Khan MA, Ambashtha AK, Kumar V, De Taboada L, Dey AB. Effect of deep tissue laser therapy treatment on peripheral neuropathic pain in older adults with type 2 diabetes: a pilot randomized clinical trial. BMC Geriatr. 2019 Aug 12;19(1):218.

Understanding low back pain: facts, figures, and solutions for better living

Posted on | by Matthew Blackwell

Low back pain (LBP) affects millions globally, with an estimated 619 million people experiencing this condition in 2020. By 2050, experts project this number will reach 843 million cases, primarily due to population growth and aging demographics. This significant increase highlights the importance of understanding and effectively managing low back pain.

The growing impact of low back pain

Low back pain stands as the leading cause of disability worldwide among musculoskeletal conditions. Its effects reach across all demographics, but particularly impacts:

  • People aged 50-55 years
  • Women more frequently than men
  • Working populations, causing significant work absences
  • Quality of life across all demographics

The economic burden of low back pain extends beyond individual suffering, affecting workplace productivity and healthcare systems worldwide. Understanding this condition and its management options becomes increasingly crucial for both healthcare providers and patients.

Understanding different types of low back pain

Low back pain manifests in various forms, each requiring specific attention and treatment approaches:

Specific vs. non-specific pain

  • Specific LBP (10% of cases): Traced to particular diseases or structural issues in the spine, often requiring targeted medical intervention
  • Non-specific LBP (90% of cases): No identifiable structural cause, but potentially linked to lifestyle factors such as low physical activity, smoking, obesity, or occupational stress

Duration categories and their implications

  • Acute: Under 6 weeks, often resolving with proper care
  • Sub-acute: 6-12 weeks, requiring increased attention to prevent chronicity
  • Chronic: Over 12 weeks, necessitating comprehensive management strategies

The science behind bracing in low back pain management

Recent scientific research confirms that lumbar support bracing plays a significant role in managing low back pain and associated disability.1 Modern bracing solutions offer multiple benefits:

  1. Range-of-motion control: Protects against painful flexion and extension movements1
  2. Core stability: Increases intra-abdominal pressure for enhanced support2
  3. Posture enhancement: Improves overall balance and alignment3
  4. Proprioception benefits: Enhances body awareness and position sense4

Understanding proprioception

Proprioception, often called our “sixth sense,” helps us understand where our body is in space. Low back pain can disrupt this crucial sense, but proper bracing can help restore these important signals between body and brain.4

DonJoy® bracing solutions for lower back pain

Enovis™ offers a specialized range of lumbar supports within its DonJoy® orthopedics brand, each designed to address specific needs and activity levels:

DonJoy Skinstrap™

For patients seeking discrete support during daily activities:

  • Lightweight elastic webbing construction
  • Second-skin feel for maximum comfort
  • Ideal for sedentary to moderate activity levels

DonJoy Porostrap 2.0™

Engineered for breathability and comfort:

  • Advanced mesh materials
  • Vented bilateral straps
  • Suitable for various activity levels
  • Enhanced airflow for extended wear

DonJoy Actistrap 2.0™

Designed for active individuals requiring additional support:

  • Adjustable bilateral straps
  • Four semi-rigid dorsal stays
  • Enhanced postural control
  • Suitable for those with muscular weakness

DonJoy Immostrap 2.0™

Advanced support for specific conditions:

  • Independent upper and lower bilateral straps
  • Flexible dorsal stays
  • Targeted postural control
  • Suitable for herniated disc conditions

For more information about managing low back conditions and finding the right support solution, visit enovis-medtech.eu.

Healthcare professionals interested in learning more about the refreshed product line can contact their local Enovis representative or visit our website for detailed product information.

References

  1. Oleiwi MA, Shah SZA, Bilal H, Zeb A, Ahmad A, Hegazye FA, Chen H. Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers. J Back Musculoskelet Rehabil. 2023;36(5):1111-1125.
  2. Ludvig D, Preuss R, Larivière C. The effect of extensible and non-extensible lumbar belts on trunk muscle activity and lumbar stiffness in subjects with and without low-back pain. Clin Biomech (Bristol). 2019 Jul;67:45-51. doi: 10.1016/j.clinbiomech.2019.04.019. Epub 2019 May 7. PMID: 31075735.
  3. Azadinia F, Ebrahimi-Takamjani I, Kamyab M, Parnianpour M, Asgari M. A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain. Med J Islam Repub Iran. 2017 May 1;31:26.
  4. Samani M, Shirazi ZR, Hadadi M, Sobhani S. A randomized controlled trial comparing the long-term use of soft lumbosacral orthoses at two different pressures in patients with chronic nonspecific low back pain. Clin Biomech (Bristol, Avon). 2019 Oct;69:87-95.
  5. WHO Facts sheet Low Back Pain 2023. https://www.who.int/news-room/fact-sheets/detail/low-back-pain.

Achilles tendonitis explained: causes, symptoms, treatments

Posted on | by Matthew Blackwell

Achilles tendonitis, also known as Achilles tendinopathy, is an overuse injury affecting the Achilles tendon. It is common among athletes and those engaged in repetitive physical activity, such as running and jumping. This article explains the causes and symptoms of Achilles tendonitis and explores the available treatments.

Causes

Achilles tendonitis often arises from excessive strain on the tendon due to overuse, improper footwear, or poor biomechanics (such as flat feet). Other contributing factors include sudden increases in activity level, weak calf muscles, or tightness in the calf or hamstring.

Athletes who engage in sports like running, basketball, or football are particularly prone to this injury, though it can also occur in people who do not warm up properly or who have abnormal foot posture.

Symptoms

The symptoms of Achilles tendonitis include pain, tenderness, and stiffness in the tendon, particularly at the back of the heel. Pain is often worse in the morning or after periods of inactivity and can be made worse by physical activity.

In some cases, swelling or thickening around the tendon may be visible, and in more severe cases, nodules may form along the tendon.

Prevention, treatment, and management of Achilles tendonitis

Preventing Achilles tendonitis involves ensuring proper training techniques, including gradual increases in the intensity and amount of exercise. Wearing appropriate footwear, stretching before physical activity, and strengthening the calf muscles can also reduce the risk of injury.

If Achilles tendonitis is already present, treatment is the next step. This generally starts with conservative measures like rest, ice, and anti-inflammatory medications. Physical therapy is crucial in managing Achilles tendonitis, particularly eccentric strengthening exercises that target the calf muscles to reduce strain on the Achilles tendon. Other interventions may include orthotics such as braces or heel lifts to reduce tendon strain, and taping to support the area during activity.

In more persistent cases, advanced treatments like shock wave therapy may be considered. Surgical intervention is typically a last resort for chronic, unresponsive cases.

Introducing AchilloForce® by DonJoy®: a new ankle support for Achilles tendonitis

For patients suffering with Achilles tendonitis, a new product by DonJoy® may offer relief. AchilloForce® is an elastic knitted ankle brace with an integrated pad covering the Achilles tendon area. This combination of compressive sleeve and cushioning pad can help deliver comfortable and easy relief and proprioception for Achilles tendon pain and inflammation.

The brace simply slides over the foot (with or without a sock on underneath) and is fixed in place by a simple two-part hook-and-loop closure at the front. Because of its slim profile, it fits easily into a shoe, and its breathable materials help the foot stay cool and dry during wear.

What’s more, AchilloForce comes with a pair of silicone heel wedges – placing one of these into the shoe underneath the heel provides extra cushioning for further relief of the Achilles tendon.

DonJoy AchilloForce Achilles tendon ankle support

To learn more about AchilloForce, visit enovis-medtech.eu

How the Defiance® PRO knee brace supports your ski and snowboard season

Posted on | by Matthew Blackwell

With winter around the corner, skiers and snowboarders are gearing up for a fresh season on the slopes. These snow sports provide a unique mix of speed, agility, and excitement—but they also bring a high risk of knee injuries, especially with the sharp turns, jumps, and high-impact landings. Whether you’re tackling moguls on skis or carving down a snowboard terrain park, the Defiance® PRO knee brace from DonJoy® offers robust protection, stability, and injury prevention for snow enthusiasts of all kinds.

Why skiers and snowboarders need knee support

Knee injuries are among the most common injuries for both skiers and snowboarders1. The rapid twisting motions in skiing, coupled with the board-fixed position in snowboarding, can put intense stress on the knee joint, especially the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Add high speeds, dynamic movement, and unpredictable falls, and it’s easy to see why additional knee protection is essential. The Defiance PRO knee brace is designed to provide that vital support and stability, whether you’re carving powder on a snowboard or navigating steep ski trails.

Key features of the Defiance® PRO for snow sports

The Defiance PRO knee brace combines clinically proven technology with a lightweight build to provide stability, prevent injury, and enhance performance without limiting your range of motion. Here’s a closer look at how this knee brace supports skiers and snowboarders alike:

1. FourcePoint® hinge technology

The brace’s FourcePoint® hinge technology is clinically proven to help protect the knee from injury2. By keeping the knee out of full and hyperextension, its dampening mechanism helps reduce the strain on the ACL that can occur during the impacts of skiing and snowboarding2.

2. Four-Points-of-Leverage™ system

The ACL is a ligament particularly vulnerable in skiing and snowboarding. The Defiance PRO’s patented Four-Points-of-Leverage™ system is clinically proven to reduce strain on the ACL by helping to prevent forward shin movement.3 For snowboarders, who face different movement patterns but similar knee stresses, this system provides the same stability against unanticipated jerks or impacts.

3. Custom fit for comfort and stability

As well as utilizing anti-migration technology, every Defiance PRO is custom-made to fit each user’s leg shape. This is crucial for skiers and snowboarders who need a stable fit without sliding or shifting. For both sports, this stability can make all the difference on sharp turns, landings, or during intense runs.

4. Lightweight carbon fiber frame

Made from carbon fiber, the Defiance PRO is engineered to withstand high impact while remaining lightweight and low-profile. Skiers and snowboarders can wear it comfortably under their snow gear without feeling weighed down, making it ideal for long sessions on the slopes. The durable frame offers protection even in rough conditions, providing peace of mind for those aiming to push their limits.

Defiance PRO knee brace

What’s new about Defiance PRO?

Skiers and snowboarders who have worn knee braces in the past may already be familiar with the name of Defiance. Building on its legacy, the new Defiance PRO retains all the features users have come to know, while introducing several enhancements.

Even lower profile

Compared to the Defiance Classic, the profile of Defiance PRO is slimmer by 5 mm, making for an even more discrete fit.

Internally mounted swiveling straps

On the new Defiance PRO, the straps are attached to the inside of the frame for a cleaner profile with less possible friction. The straps can also swivel at these connection points, helping to provide a degree of dynamic movement while retaining that all-important stability. And with their new soft-touch ends, the straps are even easier to apply and keep fastened.

More comfortable condyle pads

Defiance PRO features new condyle pads made from soft silicone for a more comfortable contact point with the knee.

New improved liners

The Defiance PRO’s new C-6 liner material is soft to the touch, moisture wicking, and anti-microbial, all of which helps keep wearers comfortable during use.

Preventing injury and supporting recovery

For skiers and snowboarders alike, injury prevention is vital to enjoying a long and active snow season. The Defiance PRO is crafted to help prevent both acute injuries (like ACL and MCL tears) and wear-and-tear injuries that can develop over time. Skiers, who face high-speed turns and quick directional changes, and snowboarders, who need support against hard impacts and rotational movements, can both benefit from the brace’s stabilizing features.

The Defiance PRO is also a helpful tool for those in recovery. If you’re returning to skiing or snowboarding after a knee injury, the brace’s targeted support can give you confidence to get back on the mountain. A re-injury rate of 5-10% for ACL injuries shows the importance of added protection4.

But don’t be fooled that this is something that only affects more mature people; secondary ACL injuries are common in adolescents too. However, at least one clinical study with young people has shown that wearing a knee brace can help prevent injury to ACL grafts following surgery.5

Make the most of your ski season with the Defiance PRO knee brace

As you gear up for ski and snowboard season, consider the added support and injury prevention that the Defiance PRO knee brace can offer. Whether you’re an experienced skier or a snowboarder hitting the terrain park, investing in a Defiance PRO can provide the security to allow you to take on the mountain without hesitation. Make this season one to remember, with knees that are fully supported for every twist, turn, and landing.

To learn more about Defiance PRO, visit our website.

References

  1. Wagner M et al. Incidence of alpine skiing and snowboarding injuries. Injury. 2023 Aug;54(8):110830. 
  2. Yu B et al. Immediate effects of a knee brace with a constraint to knee extension on knee kinematics and ground reaction forces in a stop-jump task. Am J Sports Med 2004;32(5):1136-43.
  3. Fleming BC et al. The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees. Am J Sports Med 2000;28(6):815-24.
  4. Arendt EA et al. Anterior cruciate ligament injury patterns among collegiate men and women. Journal of Athletic Training. 1999;34(2):86-92.
  5. Perrone GS et al. Risk of Secondary ACL Injury in Adolescents Prescribed Functional Bracing After ACL Reconstruction. Orthop J Sports Med. 2019;7(11):2325967119879880.

Embracing the latest in knee osteoarthritis care: ROAM OA

Posted on | by Matthew Blackwell

For orthotist Laura Aggett, delivering the best outcomes for her patients is more than just a priority—it’s a passion. As the owner and director of Lewis Brand Orthotics, a leading private orthotics practice with multiple locations in the UK, Laura constantly seeks innovative solutions that can enhance her patients’ quality of life. Her dedication frequently leads her to explore the latest advancements in orthopedic products, always aiming to find the best fit for her patients’ needs.

One of Laura’s most exciting recent discoveries is DonJoy’s new ROAM OA knee brace. Designed for individuals with moderate to severe knee osteoarthritis (OA), the ROAM OA brace offers both comfort and offloading to help alleviate pain. After learning about the product from Enovis bracing specialists, Laura was eager to offer it to her patients dealing with knee OA pain.

‘I’ve been really impressed with how the ROAM OA works and how effective it is for knee osteoarthritis patients,’ says Laura.

DonJoy ROAM OA patient

‘I’ve only received positive feedback from my patients [on ROAM OA].’

Laura Aggett, Lewis Brand Orthotics

A standout feature of the ROAM OA knee brace is its telescoping frame, which can be adjusted to accommodate patients with unique leg shapes or sizes. ‘Some patients find that certain braces rub uncomfortably on their thigh or don’t provide the necessary force to offload the affected knee compartment,’ Laura says. ‘With the ROAM OA’s telescoping frame, I can lengthen or shorten both the proximal and distal segments of the brace to ensure a better fit, or to spread the force over a greater area.’

Ease of use is at the heart of ROAM OA’s design philosophy. Given that knee OA primarily affects older adults who may also have dexterity issues1, it is essential that products tailored for them are straightforward to apply and adjust.

‘They’ve put a lot of thought into the design of the straps,’ says Laura. ‘The magnetic touch-close fastenings make it really easy for the patients. And my favorite part is the strap that leaves the knee crease free – this definitely improves comfort and compliance.’

ROAM OA cross strap

The ROAM OA brace also features a combination of strategically placed straps and adjustable BOA dials. These work together with the unique condyle harness to create a pulling force on the knee to help offload the affected compartment. ‘You don’t have to unload it completely like some braces,’ Laura says. ‘Instead, you can both increase and decrease the load through the BOA system on a step-by-step basis. That gives patients a lot more adjustability and flexibility for different activities like going up and down hills.’

Having only recently launched, the full impact of the ROAM OA brace on knee osteoarthritis patients is yet to be seen. However, early adopters like Laura are optimistic about its potential. ‘So far, I’ve only received positive feedback from my patients,’ she says. ‘I’m looking forward to fitting many more in the years to come.’

Laura recently presented her experiences of knee bracing on a webinar with Enovis. You can watch the recording here.

To learn more about the ROAM OA knee brace, visit our website.

References

  1. Pereira D, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011 Nov;19(11):1270-85.