What’s this knee brace all about anyway?

So I have severe osteoarthritis. There’s not much cartilage left in my knees and you don’t grow anymore. So that’s it. There’s no fixing the underlying problem.

What’s the causal story? I didn’t wear it out. It’s not all about weight. Lots of thin people have osteoarthritis. Mostly it’s bad genetic luck. That said, it would be easier on my knees if I weighed less. #lifegoals? I’d like to be a small person rather than a big person but I know of no way to make it so. Even at my smallest, I’m not really small.

Oddly enough while my knees look the same on the MRI and x-ray, only the left knee has been causing me pain.

I could get a knee replacement. I meet the criteria. But I’m young (and replacement knees don’t last that long) and I’m super active on my bike. The surgeon says he can’t promise full range of motion. So no to that for now.

There’s another surgical alternative, High Tibial Osteotomy. My surgeon says it’s recommended for younger, active patients. (I like that description.)

“Osteotomy literally means “cutting of the bone.” In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint. Knee osteotomy is used when a patient has early-stage osteoarthritis that has damaged just one side of the knee joint.”

That’s me. It’s my medial meniscus or the absence thereof that causes pain. That’s the inside of my knee.

See here.

“A high tibial osteotomy is generally considered a method of prolonging the time before a knee replacement is necessary because the benefits typically fade after eight to ten years. This procedure is typically reserved for younger patients with pain resulting from instability and malalignment. An osteotomy may also be performed in conjunction with other joint preservation procedures in order to allow for cartilage repair tissue to grow without being subjected to excessive pressure.”

But for now, I am trying the unloading knee brace. Like the surgery above it works by taking pressure off the part of the joint where there is direct rubbing of bone on bone.

The journal literature says that braces work but that few people, especially women, actually wear the brace. I find that shocking but also not given the number of women who run at night or work out in sheds because they are embarrassed about how they look.

Right now I’m highly motivated since things hurt a lot without the brace and not at all with the brace. I find the absence of pain and the ability to walk pretty motivating.

Here’s what the website says about the brace, “Unloader Custom is a robust solution to relieve the challenging pain typically associated with knee osteoarthritis. With a choice of twelve unique colors and a range of plus-sizes, this brace is suited for high impact and heavy-duty activities. Take control of the pain, and add a little color to your life.”

I went for shiny black. No pink knee brace for me.

How do they work? “Unloader knee braces unload the affected, painful side of the knee using a 3-Point Leverage System. The thigh and calf shells account for two points of leverage, while the Dynamic Force Strap (the diagonal strap above the knee) provides the third. This system “unloads” the pressure from the affected area, providing a reduction in pain.”

There are some practical challenges that come with wearing the brace. Skirts, it seems, do best when they’re really long or very short. It fits well over leggings. But it won’t fit under my pants. No more jeans for now.

It’s also time consuming to put on and take off.

The biggest challenge, though not for me, would have to be cost. This thing costs $1600. My benefits cover it. But without benefits that’s a big chunk of change. I guess if the literature is right that fewer than 20% of people who get braces end up wearing them, maybe it’s not cost efficient for the government to pay for them.

Also, people tend to act very alarmed when they see the brace and make their dislike clear. How long do you have to wear that for? I know they’re just upset about my knee condition and they’re not upset with me but it feels confusing. For me the brace is pretty liberating. No more pain. Yes, I’d rather I didn’t have osteoarthritis. Of course. But given that I do, I’m glad to have this choice.

Bonus: I don’t need to wear it riding the bike.

A few friends, including the kids, told me to play up the Borg angle. You will be assimilated.