unloader knee orthoses
Molly Pitcher
Description
Collection
Title:
unloader knee orthoses
Creator:
Molly Pitcher
Date:
9/21/1997
Text:
Below are a lists of responses to my question regarding unloader knee
orthoses. Thank you to all who replied. A few responses mentioned the
Breg knee orthosis. I am unfamiliar with this orthosis and if anyone
knows the phone number or web site to access info, please let me know.
I'm looking for some info on unloader knee orthoses. My patient is a 53
year old man who enjoys a vigorous tennis game. He has used an ACL knee
orthosis for many years but has had increasing medial compartment
degeneration. He wishes to remain active needing both ACL protection
and medial joint unloading. He does not want to have an osteotomy. He
is 6'4 tall and weighs approx 215. What is your experience with active
wearers using unloader knee orthoses? Thanks for any input here.
MollyPitcher CPO
_____________________________________________________________________________________
Molly, I have used the Omni Align, generation 2 and the monarch. My
least
favorite is the Align because they fit loose, are bulky at the knee, and
cause tremendous tibial pressure at the distal end. The generation 2
works
well, but can be a little confusing. The monarch works well for
unloading,
but I wouldnt put it on a heavy user anymore--I've had them lose the
correction because of just having one joint. My personal favorite is
using
the defiance with up to 4 degrees of correction. It fits well, stays in
place, and is the most low profile one I've seen. Donjoy is fabricate
it to
only unload to 4 degrees, though. In my experience, most people dont
move
over much more than that anyone, no matter where you set it.
Dulcey Lima C.O.
______________________________________________________________________________________
I have been using the Generation II unloader for some time now. I have
had
good luck with this brace.
Jim
_____________________________________________________________________________________
Molly,
The only unloaders that I have used have been for people who were
overweight- and I expect , not very active. This was not a conscious
plan on my part, it just happened that way. The best knee suppourt
that I have used for active person has been the Townsend. It seems to
work well, is simple and is much lower profile.
Good luck - and good to hear from you,
Robert
<Email Address Redacted>
__________________________________________________________________________
I believe DonJoy will modify a Defiance ACL to provide unloading force
with the ACL support.
Dan Nolan
___________________________________________________________________________
Molly, we use almost exclusively the Generation 2 unloader knee brace. A
unilateral system with a dynamic force strap. It's a custom from cast
brace, that suspends well.
There are a number of biomechanical outcome studies, but I still prefer
my
patient response. They are using the brace, with excelent results.
Try thier web site at
www.gen2.com
____________________________
The Unloader Knee Orthoses is a Don Joy product. There address and
phone
number are:
Smith & Nephew Donjoy, Inc.
2777 Loker Avenue West, Suite100
Carlsbad, Ca/ 92008
800-336-6569
Fax: 619-438-3210
Hope this helps
William Millar, B.O.C
__________________________
Most of your ACL knee orthosis companies now provide OA type knee
supports, Townends, Innovation Sports etc... I'm sure they would be
glad to send you a catalog.
_____________________________
monarch knee brace from donjoy is a good place to start.
With adjustable tension and great fit I think this would be good
for
him.
Smith & Nephew Donjoy
2777 Loker Ave. West Suite 100
Carlsbad, Ca. 92008
1-800-336-6569
_______________________________
Try a Donjoy Defiance and have them add 3 or 4 degrees of valgus. Have
them
make it as a CI configuration and a 6th strap will be added. Also ask
them
to use all chamois and include a pneumatic pad amd pump for the lateral
condyle. Increase the medial condyle width a bit to allow the
unloading.
________________________________
I have fitted a number of patients, active and in active, with the G-II
Unloader with excellent results. I don't think there is any other
device
that can give a better chance of a satisfied patient.
Don Zielke, C.O.
__________________________________
Have benn working with a similar patient forpast three years. Very
active
48yo male. Unfortunately he has bilateral ivolvement. ACL deficient on
right,
18 years SP ACL recon w medial meniscectomy on left (ex football player
in
high school). Origianlly started out with Generastion II UNloader .
Worked
well for daily activities but not high velocity activities, tennis,
skiing
and rollerblading. Switched to Townsend ACL version modified to provide
medial unloading. Tolerance and stability are much improved during
activities
but seems extreme for dialy full time wear. Patient still uses GII for
lower
velocity activities, ie hiking walking dog yard work. This patient
diplays in
excess of 10 degrees lateral diplacement bilaterally. Switching back and
forth he uses orthoses 3-6 hours per day. ( happens to be a lawyer with
sedate probate and estate type practice.) Hope this helps.
Ralph W Nobbe CPO
___________________________________This has to be the best Unloader
brace on the market, especially for the
very active person. For medial compartment OA, the joint is mounted on
the medial side only. The angulation of the joint is in valgus in
relation to the knee, which is typically genu varum. The biggest
advantage of the design of this brace is that the tension on the
diagonal force strap on the lateral aspect of the knee can be adjusted
to dynamically unload the knee from varus. If your from the USA then
you can get more info on the internet at:
<URL Redacted>
If you're in Canada:
<URL Redacted>
Hope this gives you some clinical feedback
Mark Harasimiuk, Orthotist
Caribou Orthopedic Services
_________________________________
This has to be the best Unloader brace on the market, especially for the
very active person. For medial compartment OA, the joint is mounted on
the medial side only. The angulation of the joint is in valgus in
relation to the knee, which is typically genu varum. The biggest
advantage of the design of this brace is that the tension on the
diagonal force strap on the lateral aspect of the knee can be adjusted
to dynamically unload the knee from varus. If your from the USA then
you can get more info on the internet at:
<URL Redacted>
If you're in Canada:
http://www.genII-orthotics.com/
Hope this gives you some clinical feedback
Mark Harasimiuk, Orthotist
Caribou Orthopedic Services
___________________________________
I enjoy fitting these KO's. The client's, reaction ninety percentof the
time, is my pain is gone! I have fit clients like yours to much
older
folks in nursing homes. The three I have used are the Unloader, Omni
Align,
and the Townsend. You can choose which of these is the most appropiate
for
your client.
Good Luck
_____________________________________
Molly - I've had great success treating chronic osteoarthritis or medial
compartment syndrome with the Generation 2 Unloader brace made by G2 in
Seattle. Since this is a very similar model to their ACL brace I
believe it
would work for you. I run a private practice in Florida and I've found
this
to be a superior product and a most helpful companty. E-mail me back if
you're intrested and we can discuss some pt. or contact Mike Brown @ G2
.
He's a C.O. there and an all-around great guy. One other word of
advice---
My Donjoy rep. is telling me not to use the Monarch as they're being
more
successful using the Defience with varus or valgus stress applied.
______________________________________
Dear Molly,
The two orthoses that I've used on these types of patients are the Breg
Counter force and the Donjoy Defiance with preset valgus of 3-5 degrees
and
the pneumatic knee pad. The Breg CounterForce uses a adjustable joint
that
allows you to change the angle of the orthosis( varus/valgus). Both
configurations also allow for ACL protection and both can be used on a
patient this size.
Good Luck
Carey Glass CP
________________________________________
Regarding unloaders, I have had good experience with the Generation II
unloaders. I think they are the sturdiest of the braces and he sounds
like
he would need it. They are custom made from a cast. The only complaint
we
have had is distal migration. A neoprene sleeve underneath sometimes
helps.
DonJoy makes a patient-made brace called the Monarch, which can be
adjusted
to accommodate any varus/valgus. That is a brace that I would use more
for
the Geriatric population. I think the GII would hold his knee better. I
hope
this will help you.
Sincerely, Paula Pivko, CO
_______________________________________Molly- I would consider a custom
Townsend made with the thrust to unload the
knee. I like the Townsend because it controls well for the ACL
protection and
is low profile. You can apply the medial unloading thrust that you
desire
while casting. Use the double upright design.
Stephanie Langdon-Bash CPO
__________________________________________
I have successfully used the Generation 2 Unloader knee orthoses for the
past
few years and have found great success in their fit and function.
My advise is to contact the company direct and talk to Mike Brown, C.O.
who
is there technical advisor.
They have come up with several newer variations of the original design
that
we have found to be beneficial.
Any further questions you can write back or call me at my office.
Craig A. Plattner, C.O.
Plattner Orthopedic Company
1100 Main Street
Peoria, Il. 61606
309-682-1382
_______________________________________________
try the breg counter force. I have had very good success with the custom
type
_________________________________________________
I wasn't really sold on the idea of unilateral joint configuration for
KOs,
particularly for arthritic varus/valgus unloading... until an orthotist
friend showed me the results and feed back he has gotten with the
Generation II. I have since fit 3 or 4 of them and am pleased with the
results: reduced pain and increased activity. The Gen II KOs look like
they
don't fit and the placement of the joint is absolutely screwy, but they
seem to unload, track well on the patient, and put smiles on grumpy
faces
___________________________________________________
orthoses. Thank you to all who replied. A few responses mentioned the
Breg knee orthosis. I am unfamiliar with this orthosis and if anyone
knows the phone number or web site to access info, please let me know.
I'm looking for some info on unloader knee orthoses. My patient is a 53
year old man who enjoys a vigorous tennis game. He has used an ACL knee
orthosis for many years but has had increasing medial compartment
degeneration. He wishes to remain active needing both ACL protection
and medial joint unloading. He does not want to have an osteotomy. He
is 6'4 tall and weighs approx 215. What is your experience with active
wearers using unloader knee orthoses? Thanks for any input here.
MollyPitcher CPO
_____________________________________________________________________________________
Molly, I have used the Omni Align, generation 2 and the monarch. My
least
favorite is the Align because they fit loose, are bulky at the knee, and
cause tremendous tibial pressure at the distal end. The generation 2
works
well, but can be a little confusing. The monarch works well for
unloading,
but I wouldnt put it on a heavy user anymore--I've had them lose the
correction because of just having one joint. My personal favorite is
using
the defiance with up to 4 degrees of correction. It fits well, stays in
place, and is the most low profile one I've seen. Donjoy is fabricate
it to
only unload to 4 degrees, though. In my experience, most people dont
move
over much more than that anyone, no matter where you set it.
Dulcey Lima C.O.
______________________________________________________________________________________
I have been using the Generation II unloader for some time now. I have
had
good luck with this brace.
Jim
_____________________________________________________________________________________
Molly,
The only unloaders that I have used have been for people who were
overweight- and I expect , not very active. This was not a conscious
plan on my part, it just happened that way. The best knee suppourt
that I have used for active person has been the Townsend. It seems to
work well, is simple and is much lower profile.
Good luck - and good to hear from you,
Robert
<Email Address Redacted>
__________________________________________________________________________
I believe DonJoy will modify a Defiance ACL to provide unloading force
with the ACL support.
Dan Nolan
___________________________________________________________________________
Molly, we use almost exclusively the Generation 2 unloader knee brace. A
unilateral system with a dynamic force strap. It's a custom from cast
brace, that suspends well.
There are a number of biomechanical outcome studies, but I still prefer
my
patient response. They are using the brace, with excelent results.
Try thier web site at
www.gen2.com
____________________________
The Unloader Knee Orthoses is a Don Joy product. There address and
phone
number are:
Smith & Nephew Donjoy, Inc.
2777 Loker Avenue West, Suite100
Carlsbad, Ca/ 92008
800-336-6569
Fax: 619-438-3210
Hope this helps
William Millar, B.O.C
__________________________
Most of your ACL knee orthosis companies now provide OA type knee
supports, Townends, Innovation Sports etc... I'm sure they would be
glad to send you a catalog.
_____________________________
monarch knee brace from donjoy is a good place to start.
With adjustable tension and great fit I think this would be good
for
him.
Smith & Nephew Donjoy
2777 Loker Ave. West Suite 100
Carlsbad, Ca. 92008
1-800-336-6569
_______________________________
Try a Donjoy Defiance and have them add 3 or 4 degrees of valgus. Have
them
make it as a CI configuration and a 6th strap will be added. Also ask
them
to use all chamois and include a pneumatic pad amd pump for the lateral
condyle. Increase the medial condyle width a bit to allow the
unloading.
________________________________
I have fitted a number of patients, active and in active, with the G-II
Unloader with excellent results. I don't think there is any other
device
that can give a better chance of a satisfied patient.
Don Zielke, C.O.
__________________________________
Have benn working with a similar patient forpast three years. Very
active
48yo male. Unfortunately he has bilateral ivolvement. ACL deficient on
right,
18 years SP ACL recon w medial meniscectomy on left (ex football player
in
high school). Origianlly started out with Generastion II UNloader .
Worked
well for daily activities but not high velocity activities, tennis,
skiing
and rollerblading. Switched to Townsend ACL version modified to provide
medial unloading. Tolerance and stability are much improved during
activities
but seems extreme for dialy full time wear. Patient still uses GII for
lower
velocity activities, ie hiking walking dog yard work. This patient
diplays in
excess of 10 degrees lateral diplacement bilaterally. Switching back and
forth he uses orthoses 3-6 hours per day. ( happens to be a lawyer with
sedate probate and estate type practice.) Hope this helps.
Ralph W Nobbe CPO
___________________________________This has to be the best Unloader
brace on the market, especially for the
very active person. For medial compartment OA, the joint is mounted on
the medial side only. The angulation of the joint is in valgus in
relation to the knee, which is typically genu varum. The biggest
advantage of the design of this brace is that the tension on the
diagonal force strap on the lateral aspect of the knee can be adjusted
to dynamically unload the knee from varus. If your from the USA then
you can get more info on the internet at:
<URL Redacted>
If you're in Canada:
<URL Redacted>
Hope this gives you some clinical feedback
Mark Harasimiuk, Orthotist
Caribou Orthopedic Services
_________________________________
This has to be the best Unloader brace on the market, especially for the
very active person. For medial compartment OA, the joint is mounted on
the medial side only. The angulation of the joint is in valgus in
relation to the knee, which is typically genu varum. The biggest
advantage of the design of this brace is that the tension on the
diagonal force strap on the lateral aspect of the knee can be adjusted
to dynamically unload the knee from varus. If your from the USA then
you can get more info on the internet at:
<URL Redacted>
If you're in Canada:
http://www.genII-orthotics.com/
Hope this gives you some clinical feedback
Mark Harasimiuk, Orthotist
Caribou Orthopedic Services
___________________________________
I enjoy fitting these KO's. The client's, reaction ninety percentof the
time, is my pain is gone! I have fit clients like yours to much
older
folks in nursing homes. The three I have used are the Unloader, Omni
Align,
and the Townsend. You can choose which of these is the most appropiate
for
your client.
Good Luck
_____________________________________
Molly - I've had great success treating chronic osteoarthritis or medial
compartment syndrome with the Generation 2 Unloader brace made by G2 in
Seattle. Since this is a very similar model to their ACL brace I
believe it
would work for you. I run a private practice in Florida and I've found
this
to be a superior product and a most helpful companty. E-mail me back if
you're intrested and we can discuss some pt. or contact Mike Brown @ G2
.
He's a C.O. there and an all-around great guy. One other word of
advice---
My Donjoy rep. is telling me not to use the Monarch as they're being
more
successful using the Defience with varus or valgus stress applied.
______________________________________
Dear Molly,
The two orthoses that I've used on these types of patients are the Breg
Counter force and the Donjoy Defiance with preset valgus of 3-5 degrees
and
the pneumatic knee pad. The Breg CounterForce uses a adjustable joint
that
allows you to change the angle of the orthosis( varus/valgus). Both
configurations also allow for ACL protection and both can be used on a
patient this size.
Good Luck
Carey Glass CP
________________________________________
Regarding unloaders, I have had good experience with the Generation II
unloaders. I think they are the sturdiest of the braces and he sounds
like
he would need it. They are custom made from a cast. The only complaint
we
have had is distal migration. A neoprene sleeve underneath sometimes
helps.
DonJoy makes a patient-made brace called the Monarch, which can be
adjusted
to accommodate any varus/valgus. That is a brace that I would use more
for
the Geriatric population. I think the GII would hold his knee better. I
hope
this will help you.
Sincerely, Paula Pivko, CO
_______________________________________Molly- I would consider a custom
Townsend made with the thrust to unload the
knee. I like the Townsend because it controls well for the ACL
protection and
is low profile. You can apply the medial unloading thrust that you
desire
while casting. Use the double upright design.
Stephanie Langdon-Bash CPO
__________________________________________
I have successfully used the Generation 2 Unloader knee orthoses for the
past
few years and have found great success in their fit and function.
My advise is to contact the company direct and talk to Mike Brown, C.O.
who
is there technical advisor.
They have come up with several newer variations of the original design
that
we have found to be beneficial.
Any further questions you can write back or call me at my office.
Craig A. Plattner, C.O.
Plattner Orthopedic Company
1100 Main Street
Peoria, Il. 61606
309-682-1382
_______________________________________________
try the breg counter force. I have had very good success with the custom
type
_________________________________________________
I wasn't really sold on the idea of unilateral joint configuration for
KOs,
particularly for arthritic varus/valgus unloading... until an orthotist
friend showed me the results and feed back he has gotten with the
Generation II. I have since fit 3 or 4 of them and am pleased with the
results: reduced pain and increased activity. The Gen II KOs look like
they
don't fit and the placement of the joint is absolutely screwy, but they
seem to unload, track well on the patient, and put smiles on grumpy
faces
___________________________________________________
Citation
Molly Pitcher, “unloader knee orthoses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/209981.
