How to properly wear a knee brace

In this phase, the main focus is on strengthening the leg muscles, learning to climb stairs, practicing the technique and strengthening the gait. You should use crutches for the first 1.5 to 2 months so that your body 'accepts' the prosthesis.

Orlett 303 orthosis

Orthopaedists recommend the Orlett 303 knee orthosis in the postoperative phase to restore mobility and accelerate tissue regeneration. The product should only be purchased after consulting a doctor. A poorly fitting splint can worsen the patient's condition.

Description and properties.

Buy the product from a reputable orthopedic store that issues a certificate of quality and offers a 6-month guarantee for correct use.

The knee brace firmly holds the injured area in a stable position, protecting against additional damage and excessive flexion. Immobilization is carried out from different angles, thanks to the following accessories of the 2 models listed in the table:

Features of the orthosis

The HKS-303 model stiffens the joint at an angle of 10, 20 and 30 degrees.

The PO-303 model splints the knee joint after surgery for speedy recovery and pain relief at angles of 10, 20, 40 degrees offering a range of 10, 20, 40, 60 and 90 degrees. The SO-303 brace locks the joint at -10, 20, 30° allowing for a range of motion of 5, 15, 30, 60, 90°. With the Orlett HKS-303, the immobilization of the knee joint can also be selected at 10, 20 and 30° for specific symptoms. The maximum positional range is up to 120°. Your doctor can help you choose the right model. Just choosing the right device can lead to deterioration of the affected joint.

How do I choose the size of the orthosis?

For the best therapeutic effect, it is important that the stabilizer fits tightly to the lesion and remains stable in one position. Therefore, the parameters of the orthosis should be carefully considered in relation to the patient's body dimensions. Details of model SO-303 can be found in the table below:

The table for model PO-303 shows the following correspondence:

When is a knee brace needed?

The main purpose of a knee brace is to relieve pressure and protect the joint. As a preventive measure, only compression bandages with the lowest level of fixation can be used. They are suitable for athletes and people who like to be active. The bandages help with both long-term loads (running, skiing, hiking) and short-term intense loads (lifting weights, carrying weights).

For pain and discomfort in the knee joint area, compression bandages may no longer be effective as a firmer fixation is required. In this case, it is important to see a doctor, primarily to determine the cause of the symptoms and to diagnose the problem. Orthoses can help with treatment, but cannot completely replace it. Therefore, the use of such orthoses alone does not improve the situation, but only aggravates it. Fixation of a stiff joint may be required for the following diagnoses:

A meta-analysis of six studies was presented in the journal Arthritis Care & Research, confirming that knee fixation helps reduce pain in people with osteoarthritis. However, the researchers found that the effectiveness of this method is directly related to how well the orthosis is fitted.

Is it worth using orthoses after surgery?

Until now, rigid knee braces have been recommended for the rehabilitation of patients who have undergone knee surgery. However, orthopedists are now questioning this rehabilitation method. A study was published in the Journal of Sport Rehabilitation that examined patients who had undergone anterior cruciate ligament reconstruction surgery. To facilitate the patient's recovery, doctors often recommend the use of a functional knee brace once the patient returns to physical activity. However, the study does not confirm the effectiveness of this method.

University of Alberta physicians also question the need for rigid knee fixation after such a procedure. They found that people who wore the orthosis permanently took significantly longer to rehabilitate. They also complained more often about stiffness in the joint and restricted movement. Patients who did not wear a permanent orthosis were able to return to their normal lives more quickly. For this reason, therapists believe that various physical therapy methods used to work on the knee may be more effective than permanent immobilization of the joint.

Tension with complaints

The second area of application for orthoses is the treatment of patients with diseases of the musculoskeletal system. Depending on the severity of the disease and the prognosis for healing, these tools can be used supportively (to prevent the progression of the disease) or curatively (to correct it).

The doctor prescribes orthoses for the following diagnoses:

• Postural defects: kyphosis, scoliosis, lordosis. Corsets are particularly effective for children and teenagers.
• Congenital pathologies of the musculoskeletal system. With the help of orthoses, the condition can be prevented from worsening.
• Joint diseases: arthritis, arthrosis, synovitis. Immobilizing and warming orthoses help to reduce pain and recurrences.
• Situations in which contractures may develop (inability to bend or straighten the limbs). Temporary orthoses are prescribed after injuries and fractures, permanent orthoses for neurogenic diseases, including cerebral palsy.
• Rehabilitation after a stroke when the patient has paralysis of the limbs. In this case, the orthosis will help to keep the limbs in a physiologically normal position and prevent the development of complications.
• Muscular dystrophy.
• Flat feet, dysplasia in children.

The doctor decides in each individual case whether an orthosis is necessary, what type of orthosis should be chosen and how long it should be worn. If an orthosis has been prescribed because of a medical condition, it should never be abandoned. Orthotics help prevent complications and, in some cases, prevent disability.

How to choose an orthosis: advice from an orthopedist

You can purchase a custom-made orthosis or one that is already available. In most cases, your doctor will recommend a custom-made orthosis for serious musculoskeletal disorders (e.g. contractures in cerebral palsy or spinal curvatures in congenital diseases). These are made in an orthopedic laboratory based on an impression of the affected area. In this case, the stiffening ribs can be produced using a 3D printer.

If the purpose of the orthosis is to prevent injuries or deformities, a prefabricated product can be purchased. However, a consultation with an orthopedist is essential.

• Soft (supportive) aids are prescribed for minor injuries or for preventative purposes. They are the right choice for sporting activities and to prevent poor posture in children.
• Hard (immobilizing) orthoses are equipped with special stiffening ribs made of metal, carbon fiber and other strong materials. This class of orthoses is suitable for serious injuries and progressive musculoskeletal disorders.
• Semi-rigid (plastic panels are used instead of iron). They should not be used prophylactically without a doctor's recommendation, and the moderate stiffness simply may not be enough in conditions.

It is important to pay attention to the material of the orthosis. Natural materials such as cotton and linen are ideal. However, today there are many sports braces made of spandex, which is breathable and quite flexible, and neoprene, a warming fabric that also allows good compression of the joint.

Another important detail to pay attention to when choosing an orthosis is the fasteners. Rigid models come with straps and ties, while soft models mostly come with simple Velcro closures. It is important to check how well they hold the orthosis in the correct position, otherwise the product may simply come off during sports or other physical activities.

How to wear and care for the orthosis

Place the brace on your bare leg or a thick plastic stocking. Your doctor will prescribe how long you should wear the orthosis. The wearing period is usually 1 month. Remove the brace for 20 minutes twice daily for water therapy.

The medical device must be properly washed and dried. This way it will last a long time. Remove the pads from the product beforehand. Then wash them by hand with water at 40 degrees Celsius and washing-up liquid. Do not use bleach containing chlorine. Dry the orthosis in a horizontal position. Do not expose the orthosis to sunlight. Put all parts back on after drying.

Principles for choosing a knee brace

Never try to determine the type of orthosis yourself. A knee brace that is too hard can weaken your muscles, while a brace that is too strong will slow your recovery. Therefore, the choice should be made by a qualified professional.

First of all, you should consult your doctor. He or she will examine the injured knee, diagnose the problem, and recommend treatment. A knee brace is selected in an orthopedic specialist shop by a doctor or a specialist consultant on the basis of a doctor's prescription. Read the product specifications carefully before purchasing, as the specifications of the same model can vary significantly from one manufacturer to another.

Always try on the knee brace, walk around in it for a while to see if it is comfortable and if it relieves pain. Pay close attention to the attachments of the device. It depends on how comfortable the device is to wear. If the fasteners are poor and of low quality, the knee brace needs constant adjustment. Good products usually have silicone points that attach the orthosis to the leg.

Indications for knee orthoses

• Inflammatory and degenerative processes in the joint;
• Inflammation of the tendons
• swelling of the knee;
• Injuries, including sprains and tears of ligaments, tendons and meniscus;
• Pain from old injuries, especially from untreated injuries;

Rehabilitation in the postoperative period.

In addition, wearing elastic bands is recommended for athletes who regularly subject the knee to increased loads, such as B. track and field athletes, tennis players, figure skaters, soccer players and others.

Types, actions and effects of elastic knee supports

Knee bandages made of flexible, soft fabric. Cloth bandages are similar to a bandage made from an elastic bandage, but are easier to put on and hold better. They are particularly suitable for athletes who need joint stabilization without discomfort or limited mobility.

Rails. They provide better fixation than elastic bandages and are intended for injured limbs. They are suitable for patients who regularly injure themselves due to knee instability. The splints are worn when walking or doing sports, and only for a short time and directly under load.

Suspenders. Fixes the knee joint during treatment. They are made of neoprene so they limit joint mobility without affecting the limbs. They can be soft, made only of neoprene, semi-rigid with special sealing fibers and rigid with plastic or metal inserts.

Orthoses and splints. They are suitable for serious injuries and post-surgery rehabilitation. Thanks to their rigid construction with metal or plastic inserts, they completely immobilize the joint and ensure reliable immobilization.

Medical therapy

No knee rehabilitation is without medication. There are three main types of medications prescribed after any type of orthopedic surgery:

• An antibiotic for local infections;
• an anticoagulant to thin the blood and prevent thrombosis;
• a nonsteroidal anti-inflammatory drug.

Nutritional supplements or chondroprotectors may need to be prescribed to provide valuable nutrients to the joint tissue and promote repair and regeneration responses.

Taking antibiotics is very important because they can lead to very unpleasant consequences in the form of infectious complications.

Painkillers should only be used when necessary and only if there is severe knee pain. Doctors recommend putting ice packs on the knee joint every 30-40 minutes for the first three days so as not to overdo it. Cold dry compresses are very effective in relieving pain and reducing swelling. NSAIDs should not be taken immediately before exercise so that the leg feels good during exercise. If the pain is suppressed by medication, there is a risk of moving incorrectly and inadvertently injuring the still injured limb.

Is it painful to use the operated knee without anesthesia? Of course, it will not be easy to do exercises or move at first. But you can't get rid of the pain; they are a normal and temporary response of the body to the procedure. It will get easier day by day and after about 7-10 days the discomfort will no longer be as severe. The most important thing is that you don't give up! Don't stop following your specialist's recommendations. Of course, inform your doctor or physiotherapist immediately about all your sensations, especially if the unpleasant symptoms worsen.

When do the surgical stitches need to be removed?

Postoperative knee stitches are usually removed on the 10th day. At this point, the edges of the wound secured with surgical sutures should have finally healed. If the incision is small and heals quickly, the stitches are removed on the 7th day. In general, the ability to regenerate soft tissues that have been severed during surgery varies from person to person. In older patients or those with diabetes, final healing may only occur after 12-14 days.

Judging by the scarring, this patient had a partial replacement and arthroscopy of the left knee joint. The seams look good.

How is the rehabilitation course designed?

The initial rehabilitation program is usually drawn up by the doctor who will care for the patient in the postoperative period. It will be revised after discharge from the hospital. The exercises should be performed only according to the program recommended by the doctor. The patient should be examined beforehand, and the results of X-rays and MRI scans should be reviewed.

There is no standard rehabilitation program for everyone. The program is always tailored to the individual patient.

The medical centers use both curative and non-curative methods in rehabilitation. To avoid complications after surgery, anti-inflammatory drugs, antibiotics and painkillers are prescribed.

The main component of rehabilitation is physiotherapy and treatment. The rehabilitation course is led by a rehabilitation therapist who begins with simple exercises and gradually increases the load. The patient moves from simple movements to machines and other sports equipment.

Therapy includes numerous techniques, of which physiotherapy, massage, acupuncture and reflexology are the most effective. All of them are aimed at relieving muscle tension, accelerating the healing process, eliminating pain, normalizing sleep and preventing complications.

The hip joint is one of the largest supporting joints. During a joint replacement, the ligaments are removed and the muscles that hold the prosthesis are cut and re-sewn together. These muscles need to be trained and strengthened so that they can perform their function. Otherwise, the prosthesis may shift, which can have adverse consequences.

General recommendations for the rehabilitation period

• During your hospital stay, you must learn to move safely and assume body positions that do not damage the prosthesis. For example, it is forbidden to put your leg over your foot, push your legs together while sleeping, lean on the affected leg, bend your knee while sitting, and twist and bend your leg around the prosthesis.
• Do not bend the hip more than 90° at the operated joint. There is a risk of dislocation.
• Do not sit in one position for more than 20 minutes. When sitting, the hip joints should be above the knee or at the same height. Sitting on very soft chairs is not advisable. The chair should be firm and stable, with a backrest and armrests that you can stand upright on.
• Lie in bed as follows: Sit on the bed, lift your legs and turn them towards the middle of the bed with your upper body.
• It is best to sleep on your back, with the operated leg tilted back 20° to relax the muscles.
• A pillow or bolster should be placed between the thighs to prevent unwanted movements and rotations while sleeping.
• No painkillers may be taken during physiotherapy treatment. The patient must previously adjust to the pain, through which all exercises must be performed. Otherwise, he/she may not notice when something is wrong.
• It is not advisable to drive a car for the first 1.5-2 months.
• You should not lift or carry heavy loads.
• In the first few weeks after surgery, it is important to avoid falls. You have to move very carefully and it is advisable that you have someone with you to support you in these moments.

• Walk slowly, on level and smooth surfaces;
• take steps of equal length on both legs and lean on the cane or walker for the same length;
• the sequence when climbing stairs: feet together in front of the first step, then the healthy leg, the operated leg, the support.
• Descending stairs: support, operated leg, healthy leg.

Postoperative treatment and care

Before fixation is recommended, a consultation with an angiosurgeon or phlebologist (to assess the condition of the vessels of the lower limbs) is required.

Depending on the degree of stiffening, there are different types: soft-elastic bandages without side stiffening ribs, soft-elastic bandages with side stiffening ribs, knee orthoses with non-adjustable side joints and knee orthoses with adjustable side joints. Most knee braces and supports are mass-produced. Knee braces are usually made to order.

Effect. Patients are more stable when using the device while walking (activation of proprioceptive mechanisms). By stabilizing and relieving the pressure on the knee, the pain syndrome is reduced.

Factors affecting effectiveness

Accuracy of fit and user-friendliness are important parameters. Valgies and varus corsets are effective for unfixed unstable corresponding adjustments of the lower limbs of up to 10-15°. However, the difficulty of application and removal, inconvenience and poor aesthetics mean that patients often abandon their use.

[11], [12], [13], [14], [15], [16], [17]

complications

Occasionally, compression of the soft tissues (incorrect size) can lead to circulatory problems in the limb being corrected.

If a knee brace is ineffective, surgical treatment is necessary.

[18], [19], [20], [21], [22], [23], [24]

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