Category: Knee

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. 

Radial Pressure Wave (RPW) Therapy for Total Knee Arthroplasty

Posted on | by Matthew Blackwell

For patients recovering from total knee arthroplasty (TKA), managing post-surgical pain and stiffness can present significant challenges. Radial Pressure Wave (RPW) therapy can offer a valuable treatment option, delivering targeted acoustic energy to support the healing process.

What makes Radial Pressure Wave therapy work?

RPW therapy harnesses mechanical pressure waves to encourage natural tissue repair through mechanotransduction. The process involves:

  • Compressed air propelling a metal pellet
  • Energy transfer through a specialized transducer
  • Delivery via a treatment tip into tissue
  • Radial energy distribution that gradually diminishes with depth

Customizable treatment parameters

Practitioners can adjust several variables on their RPW device to optimize treatment:

  • Pressure settings from 1-5 bars (Chattanooga® devices)
  • Multiple applicator options (plastic, steel, titanium)
  • Treatment depth capability up to 6cm with titanium applicators

Clinical experience: total knee arthroplasty patient outcomes

Physical therapist and researcher David Levine shared findings from a recent case during an Enovis™ educational webinar:

Patient Background:

  • Active male, middle-aged
  • Two months post-surgery
  • Primary concerns: lateral IT band pain, limited knee flexion

Treatment Outcomes:

  • Three RPW sessions completed
  • Enhanced range of motion noted quickly
  • Pain reduction began within days
  • Sustained improvement following initial response

RPW treatment guidelines for total knee arthroplasty patients

Key considerations include:

  1. Avoiding direct treatment over metal implants
  2. Modifying settings based on proximity to bone
  3. Maintaining patient comfort (target: 6/10 discomfort level)
  4. Expecting initial discomfort to subside within 2 minutes

Benefits observed

Patients may experience:

  • Relief from soft tissue discomfort
  • Reduced muscle pain
  • Enhanced circulation

The featured patient reported:

  • Marked pain reduction, particularly in IT band area
  • Extended relief compared to alternative treatments
  • Improved mobility

RPW therapy demonstrates significant potential for addressing post-TKA challenges, particularly in managing pain and mobility restrictions. This treatment approach may help patients achieve their recovery goals more efficiently.

To learn more about Radial Pressure Wave devices from Enovis, visit chattanoogarehab.com

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.

DonJoy OA GO® – an OA knee brace with a twist

Posted on | by Matthew Blackwell

Living with knee osteoarthritis (OA) can significantly impact daily life, making even simple activities challenging. DonJoy OA GO® is a groundbreaking knee brace designed to help alleviate pain and improve mobility for those suffering from this condition. This innovative brace features several key components that work together to help provide effective relief and support.

Innovative design and functionality

The standout feature of the DonJoy OA GO knee brace is its unique three-point offloading system, which specifically targets and offloads the affected knee compartment. This system helps to reduce the pressure on the damaged area, thereby helping to alleviate pain and discomfort.

The brace also includes dual BOA® dials that allow for easy adjustments. With a simple turn of these dials, users can customize the level of support they need, ensuring a personalized fit that caters to their specific condition.

How OA GO works

Comfort and stability

Comfort is crucial when it comes to wearing a knee brace for extended periods. The OA GO knee brace addresses this with flexible shells and anti-slip bands. These features help ensure that the brace stays in place and does not migrate during use, providing consistent support throughout the day.

Additionally, the brace is made from breathable, anti-bacterial material, which promotes hygiene and makes it suitable for long-term wear without causing irritation or discomfort.

Enhancing quality of life

The goal of the DonJoy OA GO knee brace is to help users maintain an active and fulfilling lifestyle despite their osteoarthritis. Whether you’re engaging in outdoor activities, climbing stairs, or playing with your grandchildren, this brace offers the support you need to help stay active and pain-free. The ability to adjust the brace easily means that you can tailor the support to your activity level, providing more stability or flexibility when you need it.

Versatility and availability

Half wrap, half sleeve, the OA GO knee brace combines the benefits of both to make fitting quick and easy. Simply open the thigh section then pull the lower sleeve section over the calf before securing the support with the hook-and-loop fastening.

Available in various sizes, the brace is a versatile option for individuals with different needs and body types, helping to ensure that patients can find a brace that fits them well and provides the necessary support. The ease of use and adjustability make it a convenient choice for managing mild to moderate knee osteoarthritis.

Living with knee osteoarthritis doesn’t have to mean giving up the activities you love. The DonJoy OA GO knee brace offers a practical and effective solution to manage pain and improve mobility. With its innovative design, adjustable support, and focus on comfort, this brace can help you lead a more active and pain-free life.

For more information on the DonJoy OA GO knee brace, visit www.donjoyoabraces.com/oa-go

BOA® is a registered trademark of Boa Technology, Inc.

Understanding knee osteoarthritis and how DonJoy® OA braces can help

Posted on | by Matthew Blackwell

Living with knee osteoarthritis (OA) can be a challenging experience, marked by pain and limited mobility. For those navigating this condition, finding ways to manage symptoms and maintain an active lifestyle is crucial. This is where DonJoy® OA braces come into play, offering a range of innovative products designed to alleviate pain and support knee health.

What is knee osteoarthritis?

Knee osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown of cartilage in the knee joint. This deterioration leads to pain, stiffness, and swelling, making everyday activities challenging. Common risk factors include aging, obesity, joint injuries, and repetitive stress on the knee joints.

Knee osteoarthritis diagram

The role of bracing in knee OA management

Bracing is a non-invasive treatment option that can significantly reduce pain and improve function for individuals with knee OA.1 By redistributing weight away from the affected compartment of the knee, braces help decrease pressure on the affected areas, helping to provide relief and enhance mobility.2,3

Go Roam with DonJoy OA braces

DonJoy has established itself as a leader in the field of orthopedic bracing, offering a variety of braces designed for the full spectrum of knee OA severities. Two new products in their lineup include the DonJoy OA GO® and the ROAM™ OA.

DonJoy OA GO®: This brace is designed with a unique fitting mechanism that allows for easy adjustments, helping to provide personalized pain relief and support. It’s an excellent option for individuals looking for a customizable and comfortable brace to address mild to moderate single compartment osteoarthritis.

ROAM™ OA: As the latest innovation in offloader braces, the ROAM OA offers advanced features aimed at maximizing comfort and mobility. This brace is for active individuals who need robust support without compromising their movement. Designed for moderate to severe unicompartmental knee osteoarthritis.

Why choose DonJoy OA braces?

Innovation and quality: With a legacy of over forty years of knee bracing, DonJoy is renowned for its commitment to quality and continuous innovation, ensuring our braces meet the highest standards.

Patient-centered design: Our knee osteoarthritis braces are designed with the patient’s needs in mind, offering features that enhance comfort and ease of use.

Proven effectiveness: Clinical studies and patient testimonials highlight the effectiveness of DonJoy OA braces in reducing pain and improving quality of life.3,4,5

Additional resources and support

In addition to our product offerings, we provide extensive patient education resources on our OA braces website. These resources cover various aspects of knee OA, from understanding the condition to exploring different treatment options.

If you or someone you know is struggling with knee osteoarthritis, consider speaking to a healthcare professional about the braces offered by DonJoy. With the right brace, managing knee OA can become a more manageable part of daily life, allowing for continued activity and improved well-being.

For more information on knee OA and DonJoy OA braces, visit our official website: www.donjoyoabraces.com.

References

  1. Brophy RH, Fillingham YA. AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. J Am Acad Orthop Surg. 2022 May 1;30(9):e721-e729.
  2. Nagai K, Yang S, Fu FH, Anderst W. Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients. Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2354-2360.
  3. Dries T, Van Der Windt JW, Akkerman W, Kluijtmans M, Janssen RPA. Effects Of A Semi-rigid Knee Brace On Mobility And Pain In People With Knee Osteoarthritis. J Rehabil Med Clin Commun. 2022 Jul 5;5:2483.
  4. Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA. Orthoses versus gait retraining: Immediate response in improving physical performance measures in healthy and medial knee osteoarthritic adults. Proc Inst Mech Eng H. 2020 Jul;234(7):749-757.
  5. Nagai K, Yang S, Fu FH, Anderst W. Unloader knee brace increases medial compartment joint space during gait in knee osteoarthritis patients. Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2354-2360.

Do ACL braces work?

Posted on | by Matthew Blackwell

Anterior cruciate ligament (ACL) injuries are a common concern in sports and physical activities, often requiring extensive rehabilitation and sometimes even surgery. Knee braces are one of the most prescribed devices in the orthotic industry, with medical device companies such as Enovis™ supplying a range of knee bracing solutions for ACL protection and injury prevention. But despite their widespread use, the question remains: Do ACL braces really work?

This article explores the world of ACL braces, examining their purported benefits and the scientific evidence behind their effectiveness, before presenting a new product for people looking to safeguard their knee health.

ACL injury: definition and causes

The anterior cruciate ligament (ACL) serves as an essential stabilizer within the knee joint, preventing the tibia (shine bone) from shifting forward in relation to the femur (thigh bone) and ensuring rotational stability.

While an ACL tear can occur due to excessive external force applied to the knee, it’s distinctive in that it can also happen without direct contact, which accounts for 70% of reported ACL injuries1.

In sports like football and other field/court activities, non-contact ACL injuries usually occur during abrupt stops, sudden changes in direction, or when landing from a jump with insufficient knee and hip flexion (at or near full extension)2. The typical scenario involves a combination of deceleration, directional change while the foot is planted, and the knee being near or fully extended. This action can put excessive twisting force on the ACL, leading to strain or rupture.

ACL injury

Evidence that wearing a knee brace can help prevent ACL injury

Clinical studies have demonstrated that wearing a knee brace during activity can help prevent ACL injury as well as protect against reinjury3,4,5.

In a systematic review of current evidence carried out in 2023, Tuang et al. found that protective knee braces were able to control forwards and backwards and sideways knee motion and decrease ACL load/strain during high-risk maneuvers, which may in turn decrease the risk for non-contact ACL injuries3.

With around half of ACL injuries occurring in 15–25-year-olds6, knee bracing effectiveness for young people is a key concern for many. Perrone et al.’s 2019 study involved prescribing knee braces to a group of adolescents post-ACL surgery. The results showed that post-operative use of functional bracing can result in reduced reinjury following ACL reconstruction4.

Bodendorfer et al.’s 2013 study also recommended knee bracing for ACL patients. It found that people with ACL-deficient knees can benefit from the control and proprioception functional bracing can offer. And for highly active athletes participating in high-impact sports, knee bracing further offers protection to the knee ligaments and meniscus during impact from the side5.

How DonJoy® knee braces help prevent ACL injury

DonJoy® is a name synonymous with knee bracing. A key brand of Enovis, it has been manufacturing and supplying braces for knee ligament protection since the late 1970s, using patented technology that reduces ACL strain.

The Four-Points-of-Leverage™ system featured in DonJoy knee braces consists of a rigid cuff and strap configuration. Through this, a posterior force is applied to the tibia, which prevents anterior movement and reduces the strain on the ACL7.

The second key technology in DonJoy knee braces is the FourcePoint® hinge. This complements the Four-Points-of-Leverage design by damping knee joint extension, which improves the mechanical performance of the brace and reduces shear forces at the knee. The hinge resistance kicks in during the last 25 degrees of knee extension, targeting the vulnerable “at-risk” position.

When combined, the FourcePoint hinge and the Four-Points-of-Leverage design create a more comfortable brace that diminishes anterior shear forces on the knee. This stability is particularly advantageous for people wanting to prevent ACL injuries during activity and those recovering from ACL injuries, as it eases strain on the deficient or healing ACL graft8,9.

Defiance® PRO: custom knee ligament bracing from DonJoy

When it comes to ligament knee bracing, few product names stand out more than Defiance®. Alongside off-the-shelf alternatives, DonJoy’s flagship custom brace has been protecting knees for decades. Now with the Defiance® PRO taking the design to the next level, those looking to prevent ACL injuries have a new name to trust in.

Featuring the proven Four-Points-of-Leverage and FourcePoint technologies, Defiance PRO also provides a range of customizable elements to offer patients an enhanced wearing experience.

Every Defiance PRO order begins with the patient receiving a precise measurement of their leg from an Enovis representative. These measurements are then used to build a brace exactly matched to the customer’s leg for an even closer and more comfortable fit.

Defiance PRO knee braces
DonJoy Defiance PRO knee ligament brace

Patients can further tailor their brace by choosing the frame colour from over 30 available options and adding a series of accessories, including a sports cover and silicone condyle pads for extra comfort.

With this combination of clinically proven technology and superior craftmanship, patients can be confident that DonJoy is the name to trust for knee ligament bracing.

To learn more about DonJoy knee braces, visit our website.

References

  1. Boden BP, Dean GS, Feagin JA Jr, Garrett WE Jr. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000 Jun;23(6):573-8.
  2. Silvers, H. J., & Mandelbaum, B. R. (2007). Prevention of anterior cruciate ligament injury in the female athlete. British journal of sports medicine, 41 Suppl 1(Suppl 1), i52–i59.
  3. Tuang, B.H.H., Ng, Z.Q., Li, J.Z., Sirisena D. (2023). Biomechanical Effects of Prophylactic Knee Bracing on Anterior Cruciate Ligament Injury Risk: A Systematic Review. Clin J Sport Med. Jan 1;33(1):78-89.
  4. Perrone, G.S., Webster, K.E., Imbriaco, C., Portilla, G.M., Vairagade, A., Murray, M.M., Kiapour, A.M. (2019). Risk of Secondary ACL Injury in Adolescents Prescribed Functional Bracing After ACL Reconstruction. Orthop J Sports Med. Nov 12;7(11):2325967119879880.
  5. Bodendorfer, B.M., Anoushiravani, A.A., Feeley, B.T., Gallo, R.A. (2013). Anterior cruciate ligament bracing: evidence in providing stability and preventing injury or graft re-rupture. Phys Sportsmed. Sep;41(3):92-102.
  6. Griffin LY, Albohm MJ, Arendt, EA, et al. (2006). Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries: A Review of the Hunt Valley II Meeting, January 2005. Am J Sports Med 34(9):1512-32
  7. Fleming, B. C., Renstrom, P. A., Beynnon, B. D., Engstrom, B., & Peura, G. (2000). The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees. The American journal of sports medicine, 28(6), 815–824.
  8. Théoret, D., & Lamontagne, M. (2006). Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 14(6), 555–563.
  9. Stanley, C. J., Creighton, R. A., Gross, M. T., Garrett, W. E., & Yu, B. (2011). Effects of a knee extension constraint brace on lower extremity movements after ACL reconstruction. Clinical orthopaedics and related research, 469(6), 1774–1780.

Say goodbye to knee pain and hello to ROAM™ OA: the latest innovation in OA braces from DonJoy®

Posted on | by Matthew Blackwell

Knee osteoarthritis (OA) is a painful condition that affects over 650 million people worldwide1. Occurring predominantly in those aged 40 and over, the barrier to activity it presents can have a debilitating effect on both the physical and mental health of sufferers. Thankfully, knee braces have been shown to have a positive effect on the symptoms of OA2, and with the release of ROAM™ OA, DonJoy® has a new way to help OA patients reduce knee pain and stay active and healthy.

Comfortable, easy to use, and effective

Regular use of offloader knee braces has been shown to contribute to improved daily functioning, reduced pain, and enhanced mobility, ultimately leading to a better quality of life2. ROAM OA is designed to improve mobility and provide relief by unloading the pressure of moderate to severe unicompartmental osteoarthritis or other knee pain. Its lightweight, low-profile joint offloading and support system offer a high level of comfort while remaining user-friendly for both prescribers and patients.

Designed for diverse patient needs

Whether for conservative care or as a preparation for surgery, ROAM OA’s series of adjustable settings cater to a wide range of patients looking to enhance their activity levels and maintain an active lifestyle.

To address the most challenging fitting needs, ROAM OA is also available in a custom-made version. Tailored to individual measurements, this option ensures a unique fit with custom-positioned condyle and uprights, optimal height setting, and personalized cuff sizes and strap lengths.

ROAM OA knee brace

Features and benefits

With a patient-focused approach, ROAM OA’s list of features ensures ease of use and aids compliance.

Once set by a trained fitter, the “set and forget” straps provide a visual guide for patients to help make donning and removing the brace simple and worry-free.

The patented Mag-Align magnetic buckles provide an audible “snap” on connection, instilling confidence in patients, even those with eyesight or dexterity challenges.

The BOA® Fit System allows patients to easily dial in support and pain relief on demand. Simply turn the dials to increase tension in the brace, or pull them out for quick release.

And patent-pending comfort straps and a condyle harness help negate migration of the brace while enhancing comfort by leaving the popliteal fossa area behind the knee free from friction.

To learn more about ROAM OA, visit our website: https://goto.enov.is/tW0PPi

*BOA® is a registered trademark of BOA® Technology Inc.

References

  1. Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020 Nov 26;29-30:100587.
  2. Feehan NL, Trexler GS, Barringer WJ. The Effectiveness of Off-Loading Knee Orthoses in the Reduction of Pain in Medial Compartment Knee Osteoarthritis: A Systematic Review. J Prosthet Orthot 2012;24(1):39-49.

10 reasons why skiers and snowboarders should wear a DonJoy® knee brace

Posted on | by Matthew Blackwell

As winter sports enthusiasts hit the slopes, the importance of protecting vulnerable joints cannot be overstated. For skiers and snowboarders, the rigors of downhill adventures can take a toll on the knees. Thankfully DonJoy® knee braces are clinically proven to protect the knee and safeguard against ligament injuries.1 Here are ten compelling reasons why skiers and snowboarders should consider wearing a DonJoy rigid knee ligament brace.

1. Dynamic Stability

The unpredictable terrain of snowy slopes demands dynamic stability. DonJoy knee braces feature the Four-Points-of-Leverage™ system, a combination of a rigid cuff and straps that provides a constant dynamic load and is clinically proven to reduce anterior cruciate ligament (ACL) strain.2

Four points of leverage

2. Prevent Ligament Injuries

The lateral movements and sudden stops inherent in skiing and snowboarding can put stress on knee ligaments, and when it comes to ligament injuries, prevention is better than any cure. DonJoy’s patented FourcePoint® Hinge keeps the knee out of the “at risk” position, helps prevent anterior tibial translation, and dampens knee joint extension, helping to protect the knee from injury.3

FourcePoint hinge

3. Post-Injury Protection

With a re-injury rate of 5-10% for people who have suffered an ACL injury, protecting the knee is essential.4 The Four-Points-of-Leverage technology featured on DonJoy knee braces effectively reduces ACL strain, which can be crucial during rehabilitation while the graft is remodelling.2

4. Enhance confidence

The protection offered by a DonJoy brace can give skiers and snowboarders the confidence to push their limits with greater assurance.

5. Important for women and young people

Of those who suffer ligament injuries, women and young people are the most susceptible. With 50% of ACL injuries occurring in 15-25 year olds,5 and women 8x more likely to injure an ACL,6 it is even more essential for them to wear a knee brace while skiing or snowboarding.

6. Unique braces made to measure

Every Defiance and A22® knee brace is made to the specific measurements of the customer’s leg for an even closer and more comfortable fit.

7. Off-the-shelf options for a fast fix

For customers not looking for a custom option, DonJoy offers a wide choice of off-the-shelf knee braces. Armor™ comes in 7 different sizes of thigh circumference for fast and simple measuring and ordering.

8. Customise your brace to suit

DonJoy’s Defiance knee braces offer a range of customisable features to suit customers. Along with optional accessories including a sports cover and silicone condyle pads, these braces are also available in over 30 frame colours and patterns.

Defiance PRO knee braces
Defiance knee braces

9. DonJoy braces won’t get in the way

Thanks to their lightweight, low-profile design, DonJoy knee braces fit easily under ski trousers and snowboard pants. Many of the braces are also available in a short calf length to ensure boot clearance.

10. There’s more than just bracing

DonJoy knee braces are complemented by a huge range of medical devices provided by its co-brands in the Enovis™ organisation. Whether it is cold therapy products to reduce pain following injury, or electro muscle stimulation devices to aid in recovery, Enovis offers support for skiers and snowboarders throughout the continuum of care.

To learn more about DonJoy knee braces, visit enovis-medtech.eu

References

  1. Ackerman DR et al. Prophylactic Knee Bracing in Offensive Linemen of the National Football League: A Retrospective Analysis of Usage Trends, Player Performance, and Major Knee Injury. Orthop J Sports Med. 2023 Aug 25;11(8):23259671231191767.
  2. 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.
  3. 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.
  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. Griffin LY et al. Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries: A Review of the Hunt Valley II Meeting, January 2005. American Journal of Sports Medicine. 2006 34:9. 1512-1532.
  6. Mancino F et al. Anterior cruciate ligament injuries in female athletes. Bone Joint J. 2023 Oct 1;105-B(10):1033-1037.

Why are there more ACL injuries in women’s football?

Posted on | by Matthew Blackwell

With the World Cup kicking off in Australia and New Zealand this year, the popularity of women’s football (soccer) is at an all-time high, with more women and girls getting involved every day. However, female football players are at a higher risk of anterior cruciate ligament (ACL) injuries compared to their male counterparts.1 Why are there more ACL injuries in women’s football, and how can knee bracing help in prevention and protection?

What is an ACL injury and how do they happen?

The anterior cruciate ligament (ACL) is one of the major stabilizing ligaments in the knee joint. Running diagonally in the middle of the knee, it prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee.

ACL injury

Although the ACL can be torn when the knee receives excessive external force, unlike most other ligaments it can also be injured in non-contact situations, with the latter accounting for 70% of all reported ACL injuries.2

In football and other field/court sports, non‐contact ACL injury typically involves a sharp stop, a sudden change of direction, or landing from a jump with inadequate knee and hip flexion (at or near full extension).1 The most common occurrence is from a combination of a deceleration manoeuvre with a change of direction while the foot is planted and the knee is nearly or fully extended; the excessive torsional force that results from the player trying to change direction can potentially strain or rupture the ACL.

Why ACL injuries are more common in female footballers

Studies have shown that female athletes are two- to ten-times more likely to suffer an ACL injury than male athletes.1 The phenomenon has had a noticeable impact on the 2023 Women’s World Cup, with several high-profile players missing out on the tournament as a result. There are a number of factors involved.

Differences in anatomy

The anatomy of female players predisposes them to an increased incidence of ACL injuries. Women generally have slimmer muscles, and a more considerable pelvic angle than men. The Q-angle, which refers to the angle formed between the hip and the knee, is higher in females, leading to more exertion placed on the ACL. The variance in the anatomy of the knee joint and surrounding bones results in lower overall knee stability, amplified by repetitive jumps or twists.

Hormonal predisposition

Research has suggested that the menstrual cycle poses a higher risk for ACL injuries during ovulation.3 Estrogen levels are higher during ovulation; high estrogen levels alter the collagen production, resulting in increased ligament laxity which can lead to decreased levels of overall knee stability.

Biomechanical Aspects

Studies have revealed distinct differences in landing techniques between men and women following a jump or leap.4 Females have landing mechanisms which increase the pressure placed on their knees. Furthermore, females are more likely than males to land with knee valgus position, making it harder to control the forces and positions during motions leading to tearing of the ACL.

How a knee brace can help reduce ACL injuries

Clinical studies have demonstrated that wearing a knee brace during activity can help prevent ACL injury as well as protect against reinjury.5,6,7 DonJoy® knee braces utilize patented technology that reduces ACL strain.

The Four-Points-of-Leverage™ system featured in DonJoy knee braces consists of a rigid cuff and strap configuration. Through this, a posterior force is applied to the tibia, which prevents anterior movement and reduces the strain on the ACL.8

Four points of leverage

FourcePoint® hinge technology works to enhance DonJoy’s Four-Points-of-Leverage design by damping knee joint extension, which improves the mechanical performance of the brace and reduces shear forces at the knee. Addressing the “at-risk” position, the hinge resistance engages in the last 25 degrees of knee extension.

FourcePoint hinge

The FourcePoint hinge combined with the Four-Points-of-Leverage cuff and strapping design provides a more comfortable brace that reduces anterior shear forces at the knee. The stability this provides is beneficial for both female football players looking to avoid ACL injuries during training, and those who are recovering from an existing injury, as it reduces strain on the healing ACL graft.9,10

To find out more about DonJoy knee braces, go to enovis-medtech.eu.

References

  1. Silvers, H. J., & Mandelbaum, B. R. (2007). Prevention of anterior cruciate ligament injury in the female athlete. British journal of sports medicine, 41 Suppl 1(Suppl 1), i52–i59.
  2. Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train 1999;34(2):86-92.
  3. Yu, W. D., Liu, S. H., Hatch, J. D., Panossian, V., & Finerman, G. A. (1999). Effect of estrogen on cellular metabolism of the human anterior cruciate ligament. Clinical orthopaedics and related research, (366), 229–238.
  4. Butler, R. J., Willson, J. D., Fowler, D., & Queen, R. M. (2013). Gender differences in landing mechanics vary depending on the type of landing. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 23(1), 52–57.
  5. Tuang, B.H.H., Ng, Z.Q., Li, J.Z., Sirisena D. (2023). Biomechanical Effects of Prophylactic Knee Bracing on Anterior Cruciate Ligament Injury Risk: A Systematic Review. Clin J Sport Med. Jan 1;33(1):78-89.
  6. Perrone, G.S., Webster, K.E., Imbriaco, C., Portilla, G.M., Vairagade, A., Murray, M.M., Kiapour, A.M. (2019). Risk of Secondary ACL Injury in Adolescents Prescribed Functional Bracing After ACL Reconstruction. Orthop J Sports Med. Nov 12;7(11):2325967119879880.
  7. Bodendorfer, B.M., Anoushiravani, A.A., Feeley, B.T., Gallo, R.A. (2013). Anterior cruciate ligament bracing: evidence in providing stability and preventing injury or graft re-rupture. Phys Sportsmed. Sep;41(3):92-102.
  8. Fleming, B. C., Renstrom, P. A., Beynnon, B. D., Engstrom, B., & Peura, G. (2000). The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees. The American journal of sports medicine, 28(6), 815–824.
  9. Théoret, D., & Lamontagne, M. (2006). Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 14(6), 555–563.
  10. Stanley, C. J., Creighton, R. A., Gross, M. T., Garrett, W. E., & Yu, B. (2011). Effects of a knee extension constraint brace on lower extremity movements after ACL reconstruction. Clinical orthopaedics and related research, 469(6), 1774–1780.