Tag: Knee

Living with Knee Osteoarthritis: How Knee OA Bracing Can Help Reduce Pain and Delay Surgery

Posted on | by Matthew Blackwell

Knee osteoarthritis (OA) is one of the most widespread musculoskeletal conditions in the world — and its impact on daily life can be profound. Whether you are a patient struggling to walk to the local shops, or a clinician searching for effective conservative management options, understanding the role of knee OA bracing is increasingly important. The evidence is compelling: the right brace, fitted correctly, can reduce pain, improve mobility, and in some cases delay or even prevent the need for surgery.

Knee OA: A Background

Knee OA affects an estimated 22.9% of people aged 40 and over — that is 654 million people globally in this age group alone.1 Radiographic evidence of knee OA is even more prevalent, detected in 28.7% of the population across all ages, though not all cases are symptomatic.1 The World Health Organization estimates that 344 million people living with osteoarthritis (across all joints) experience moderate or severe levels that could benefit from rehabilitation.2

For many patients, the journey from early symptoms to the operating theatre is a long one. Research by London et al. calculated that approximately 20% of American patients with symptomatic knee OA linger in what is known as the “treatment gap” — the period after conservative treatments have been exhausted but before surgical intervention — for up to 10 years. For younger patients, this gap can stretch to 20 years, a significant period of pain, reduced activity, and diminishing quality of life.3

Understanding the Vicious Cycle of Knee OA

Knee OA does not progress in a straight line. It is driven by a self-reinforcing cycle of interconnected problems. Malalignment of the knee — where the joint is not tracking correctly — leads to aberrant biomechanics and increased compartment loading, which in turn causes pain. Pain leads to decreased activity, which contributes to weight gain and muscle weakness, which further destabilizes the joint, and so the cycle continues.

Conventional pharmacological approaches such as analgesics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can reduce pain and improve quality of life, but they do not address the underlying biomechanical causes of OA. There is also evidence that increased pain-free activity or walking speed following medication use may actually lead to increased joint loading4 and accelerated disease progression5 — a counterintuitive but important consideration for clinicians.

This is where off-loading knee bracing offers something fundamentally different.

How Knee OA Bracing Can Break the Cycle

A well-designed knee OA brace works by physically altering the forces acting on the knee during movement. The clinical evidence supporting this mechanism is substantial.

Increasing joint space

Research using highly accurate biplane radiography demonstrated in patients with medial knee OA that wearing a DonJoy OA Defiance brace can induce a significant increase of 0.3 mm in medial compartment dynamic joint space during gait — roughly a 10% increase during the impact phase of walking. This improvement was consistent from heel strike to terminal stance, meaning the joint is protected throughout the most demanding part of each step.6

Correcting malalignment

OA braces have been shown to shift the knee into a more corrected position in patients with varus (bow-legged) knees7,8 with the greatest corrective effect occurring at approximately 10% of the gait cycle — precisely the point of greatest loading.8,9 A biomechanical study using the OA Adjuster brace found a difference of 4° in varus angle between braced and unbraced conditions, a clinically meaningful correction.9

Reducing knee adduction moment

The knee adduction moment — the force that drives compression on the medial side of the joint — is a key driver of medial compartment OA progression. OA braces have been shown to reduce peak knee adduction moment by up to 32% during gait,7,9,10 with greater reductions achieved when the brace hinge is dialled in further.10 The adduction impulse, which accounts for both load and loading time, can be reduced by up to 37%.10

Improving stability and confidence

Muscle weakness and decreased stability contribute to reduced patient confidence in movement. OA bracing has been shown to improve both perceived and objective knee stability,11,12,13 which encourages patients to move more — breaking the inactivity cycle rather than perpetuating it.

The Impact of Knee OA on Pain and Everyday Life

The clinical outcomes for pain relief are striking. In a systematic review by Feehan et al. that included 15 clinical studies, 98.6% of 567 patients with medial knee OA experienced pain relief when fitted with an off-loading brace.14 In another study, both custom and off-the-shelf brace options produced significant reductions in pain and stiffness, with custom bracing also showing meaningful improvements in function.7

The effect on daily mobility is equally significant. A patient feedback study by Dries et al. (2022) found that wearing an OA Defiance brace considerably expanded mobility across all patient groups.15 The proportion of patients confined to their home environment reduced by 74%, while 42% of brace wearers reported being able to take a long walk or visit a local shop — activities that had previously been out of reach. This is not a minor quality-of-life improvement; for many patients, it represents a return to independence.

Can Knee OA Bracing Delay Surgery?

One of the most important questions for both patients and healthcare systems is whether bracing can delay or reduce the need for surgical intervention. The evidence here is encouraging.

A study by Lee et al. (2017) found that patients who wore an off-loading knee brace for two years or more did not require surgery at eight-year follow-up.16 Given that the off-loading knee brace is a cost-effective treatment option, its potential as a bridging therapy — reducing the burden of the treatment gap on both patients and healthcare systems — is considerable.16,17

A Place in Every Stage of Treatment

Modern OA bracing is not a one-size-fits-all solution. Braces are now designed to address a spectrum of OA severity, from early-stage support through to moderate and severe disease. This means clinicians can tailor brace selection to the individual patient’s needs, activity level, and degree of joint involvement.

For patients, the message is equally clear: living with knee OA does not have to mean accepting a steady decline in mobility and independence. For healthcare professionals, the evidence supports placing OA bracing earlier and more consistently in the conservative management pathway — not as a last resort before surgery, but as an active intervention that can protect the joint, relieve pain, and keep patients moving.

DonJoy® Knee OA Braces: For Every Stage of Osteoarthritis

Under the DonJoy® brand, Enovis™ offers a full portfolio of braces for all severities of knee OA and levels of patient activity.

DonJoy OA GO® helps provide relief from pain and mobility issues caused by mild to moderate knee osteoarthritis.17 With a simple twist of a dial, this innovative soft knee brace’s three-point offloading system quickly offloads the affected compartment to help relieve pain and ease movement.

ROAM™ OA helps patients say goodbye to knee pain. From picking up their grandkids to teeing off at the driving range, lightweight, low-profile joint offloading and support never felt so good—or was so easy to prescribe. ROAM helps improve mobility and provides relief by offloading the pressure of unicompartmental osteoarthritis or other knee pain.17

OA Nano™ is our lightest functional knee brace for mild to moderate osteoarthritis. Powered by DonJoy’s clinically proven Adjuster™ technology,17 it combines targeted offloading with minimal weight, helping patients maintain their activity levels in comfort. The flexibility of the streamlined aluminum frame allows for an intimate fit while providing offloading to support pain relief. OA Nano is designed to help people stay active and move freely, making patient compliance a reality.

For more information about managing knee osteoarthritis and finding the right support, visit donjoyoabraces.com.

Healthcare professionals interested in learning more about knee OA braces can contact their local Enovis representative or visit our website for detailed product information.

References

  1. Cui A, Li H, Wang D, et al. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020;29–30:100587.
  2. WHO July 2023 Osteoarthritis Key Facts. https://www.who.int/news-room/fact-sheets/detail/osteoarthritis
  3. London NJ, Miller LE, Block JE. Clinical and economic consequences of the treatment gap in knee osteoarthritis management. Med Hypotheses. 2011;76(6):887–92.
  4. Schnitzer TJ, Popovich JM, Anderson GBJ, Andriacchi TP. Effect of piroxicam on gait in patients with osteoarthritis of the knee. Arthritis and Rheumatism. 1993;9:1207–13.
  5. Huskisson EC, Berry H, Gishen P, et al. Effects of antiinflammatory drugs on the progression of osteoarthritis of the knee. Journal of Rheumatology. 1995;22:1941–6.
  6. 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;27(7):2354–2360.
  7. Draganich L, Reider B, Rimington T, et al. The effectiveness of self-adjustable custom and off-the-shelf bracing in the treatment of varus gonarthrosis. J Bone Joint Surg Am. 2006;88(12):2645–52.
  8. Richards J, Jones R, Kim W. Biomechanical changes in the conservative treatment of medial compartment osteoarthritis of the knee using valgus bracing. ICRS 2006.
  9. The Comprehensive Textbook of Clinical Biomechanics, 2nd Edition. Elsevier 2018.
  10. Orishimo KF, Kremenic IJ, Lee SJ, et al. Is valgus unloader bracing effective in normally aligned individuals. Knee Surg Sports Traumatol Arthrosc. 2013;21(12):2661–6.
  11. Hart HF, Collins NJ, Ackland DC, et al. Immediate Effects of a Brace on Gait Biomechanics for Predominant Lateral Knee Osteoarthritis and Valgus Malalignment After ACL Reconstruction. Am J Sports Med. 2016;44(4):865–73.
  12. Hart HF, Crossley KM, Collins NJ, Ackland DC. Bracing of the Reconstructed and Osteoarthritic Knee during High Dynamic Load Tasks. Med Sci Sports Exerc. 2017;49(6):1086–1096.
  13. Kwaees TA, Richards J, Rawlinson G, et al. Can the use of proprioceptive knee braces have implications in the management of osteoarthritic knees. Prosthet Orthot Int. 2019;43(2):140–147.
  14. 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.
  15. Dries T, Van Der Windt JW, Akkerman W, et al. Effects of a semi-rigid knee brace on mobility and pain in people with knee osteoarthritis. J Rehabil Med Clin Commun. 2022;5:2483.
  16. Lee PY, Winfield TG, Harris SR, et al. Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis. BMJ Open Sport Exerc Med. 2017;2(1):e000195.
  17. Mistry DA, Chandratreya A, Lee PYF. An Update on Unloading Knee Braces in the Treatment of Unicompartmental Knee Osteoarthritis from the Last 10 Years: A Literature Review. Surg J (N Y). 2018;4(3):e110–e118.

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.

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. 

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. 
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