Knee Orthoses Custom and Custom Fit

There are two bones in the lower leg, one bone in the upper leg, and a sesamoid bone that together create three joints.


The bones are:

• Femur (upper leg)
  
• Tibia (lower leg)
  
• Fibula (lower leg)
  
• Patella/ knee cap

Three knee joints are:

• Tibiofemoral joint
• Patellofemoral joint
• Superior tibia fibular joint

There are many muscles, tendons, ligaments and nerves in the knee.
The Ligaments of the knee are:

• ACL - anterior cruciate ligament
  
• PCL - posterior cruciate ligament
  
• MCL - medial collateral ligament
  
• LCL - lateral collateral ligament
  
• MPFL - medial patellofemoral ligament
  

• Provide knee stability, prevent knee hyperextension
• Control biomechanical alignment of the knee in locomotion
  
• Aid in adaption to surfaces
  
• Redistribute pressures on the knee
  
• Resist external forces on the knee
  
• Limit excessive movements in the knee
  
• Protect the knee
  
• Provide shock absorption
  
• Produce a more energy efficient gait pattern 
  

A Certified Orthotist will assess the knee and take a 3-D cast/mould of the knee if needed.  This can be performed with the patient in a prone position, in a seated position, or standing.  The Certified Orthotist will ensure the knee is in a corrected position.

There are a variety of knee orthoses designs. The Certified Orthotist will determine which design is best for treatment based on individuals’ needs and goals.  The custom knee orthosis will have joints at the knee and will have a metal or thermoset resin frame.  All knee braces have straps to help ensure correct application of the orthosis .

Knee orthoses work best when applied directly against the skin.  The knee brace will have specific donning (application) instructions that the Certified Orthotist will explain to the patient.

Living with Knee Orthoses (follow up)

The correction provided by the knee orthosis may take some time to get used to.  The knee orthosis should not be painful, however, it is not uncommon to feel some initial discomfort.  The break-in period should not last more than two weeks. If you experience rubbing or blisters, please book an appointment with your Certified Orthotist for immediate attention.  If you are experiencing pain after two weeks please book a follow up appointment with your Certified Orthotist.

It is always a recommended to book a follow up appointment with your Certified Orthotist if you experience any changes in condition (pain, growth).  The Certified Orthotist can determine what changes need to be made or make recommendations for alternative treatment.  It may be possible to modify or refurbish the custom knee orthosis.  The Certified Orthotist can reassess to determine the course of treatment with you.

Alberta Aids to Daily Living (AADL) does provide funding for custom knee orthoses for Alberta Residents with valid Alberta Healthcare if you qualify.  AADL will pay 100% for the cost for Alberta Residents over the age of 65.  AADL will pay 75% of the cost for Alberta Residents under the age of 65.  A prescription from a physician is required and in some cases further medical reports.  In some cases there would be an upgrade charge that is not covered by AADL and would be the patient’s responsibility.  There is coverage for persons with low income.

• OTS knee braces may not qualify for government funding.
• WCB may provide coverage with a copy of a prescription from a physician.
• NIHB may provide coverage with a copy of a prescription from a physician. 
• Private insurance may pay for a portion of the cost of your custom knee orthosis.  It is important to consult your insurance company to determine the coverage that they provide. 
• Many insurance companies require a physician's prescription for custom knee orthoses benefits.  Some insurance companies may request a biomechanical analysis from the Certified Orthotist.  There may be an added cost for the Certified Orthotist to provide this report.