Orthotics, walking aids, unloader braces and household aids are valuable in patients with arthritic knee pain.
First published in 2016, and reviewed August 2023 by Dr Sheila Strover (Clinical Editor)
Knee arthritis may be associated with discomfort both with movement and during sleep. The following may be useful:
Orthotics for knee arthritis
Orthotics are mechanical devices that are worn to physically assist in correcting poor alignment or function of a limb or the spine. In the arthritic knee a simple sorbo-rubber shoe insert may soften impact on the joint. Shoes themselves should have flexible heels. Canes should have anatomical handles to afford a good grip and these should be bought for left- or right-handedness. Ferrules should be chosen to reflect the kind of use that the stick will have, and there are special flexible ones for rough surfaces and you can also buy spiked straps to go around the ferrules for icy conditions.
Arthritis, Foot Pain & Shoe Wear: Current Musculoskeletal Research on Feet.Riskowski J, Dufour AB and Hannan MT. Curr Opin Rheumatol. 2011 Mar; 23(2): 148–155.
Household aids for arthritics
An aid is an external device that makes things easier to do.
- offer support - stair rails, bath rails, shower bars, walking canes
- help with dressing - stocking pullers, long shoe horns
- getting out of armchairs - uplift seat
- going upstairs - stair lifts
- doing chores - reachers
- sleeping - knee pillow
Unloader braces
Unloader braces are relevant in those patients where arthritis affects one half of the joint, for example where arthritis has followed a previous meniscus injury. They are designed to take the load off the damaged side and transfer it to the undamaged side. They are of particular relevance in patients who:
- wish to delay osteotomy (surgical correction of bony deformity) or knee arthroplasty
- are unfit or too old for such surgery or who are reluctant to have surgery.
but are probably likely to be avoided in patients who:
- are obese, as it may be difficult to achieve optimal brace fixation
- are severely affected but too young for knee replacement, in whom osteotomy is likely to be the preferred choice of management
- have a severe valgus (knock knees) as the good leg may chafe against the joint of the brace on the inner side
Studies generally show that unloader braces in the right patient diminish pain, increase walking tolerance and provide better function, although there is no difference in dynamic gait parameters (the pattern of the limp or walk), nor significant improvements in stair climbing or squatting.