365 Days 365 Business Ideas: Start a Osteoarthritis Knee, Elbow,Shoulder,Ankle Support Braces Business

(313). Start a Osteoarthritis Knee, Elbow,Shoulder,Ankle Support Braces Business
Dynamic bracing is the use of muscle power to cause a brace to work against the pathological movement of a joint. In the case of the knee, different pathological movements are possible depending on which stabilizing structures are injured. It is necessary to determine which structures are damaged, then to discover at what point in the range of motion these abnormal movements occur. This information permits designing an orthosis that uses leg extension or flexion to precompress soft tissues with increasing force to prevent pathological motion as the leg approaches the range where instability occurs. Good examples of pathological conditions which can be addressed with this type of brace are found in ACL deficient knees and knees with medial or lateral gonarthrosis.
Functional bracing is intended to reduce or eliminate the instability of the knee following ligamentous injury. It is currently indicated for frequent episodes of "giving way", poor quadriceps and hamstrings strength, high ligamentous laxity, and the desire to return to competitive sports. Patients who wore functional braces reported fewer episodes of giving way, decreased pain and swelling, increased confidence, and an increased ability to return to their former level of activity. The stability and comfort of functional braces depends on many factors including the design and proper placement of the brace. To better understand brace design, it is first necessary to understand the factors that limit and enhance control of the leg.

The greatest factor that limits control of abnormal movements by any external support device, including braces, is soft tissue movement and compression. Figure A shows a typical soft tissue compression curve of a 5cm wide strap on the posterior hamstrings. Using traditional orthotic principles, optimization of control involves increasing brace length to increase leverage, and increasing surface contact area of the straps and shells to reduce tissue compression for a given force level (Fig B). There is an upper limit to this approach in terms of the

permissible placement of straps and shells to achieve movement of the leg. Figure C shows that it is possible to achieve 20 mm of tibial subluxation with only 10 mm of hamstrings compression using typical design limitations. It is very easy to achieve this amount of compression during leg extension because the hamstrings are acting only as antagonists. This explains why traditional orthoses have difficulty in limiting tibial movement at forces experienced during sports play.

Braces with no net shear force can be termed passive braces (Fig D).

Large subluxations are possible before soft tissue is compressed enough to provide high resistance (Fig E).

It is possible in some brace designs to adjust strap tension to precompress soft tissue by placing a preloaded shear force against the knee. These braces can be termed static

counter force braces (Fig F). Although some increase in control force is possible, circulation places a limit on the amount of

preload possible in a static tensioned strap (Fig G).

Dynamic bracing uses the act of leg extension to place an increasing shear force across the knee as the leg is extended (Fig H). This effectively precompresses the soft tissues to

very high levels dependent on design and patient tolerance (Fig I). The force is reduced as the leg is flexed so that circulation is not inhibited during sports play. This movement against the knee is readily apparent when the brace is seen in motion. Many braces may lack mechanical effectiveness but enhance the ability to sense abnormal movements in a symptomatic knee.

Dynamic braces provide varying compressive forces against the leg that the patient can correlate with angle to enhance joint position sense and restore quadriceps function in symptomatic knees. In two recent studies, Acierno et al ^46,47, demonstrated the effect of dynamic braces on normal and ACL deficient knees using EMG during maximal effort isokinetic extension. It was shown that asymptomatic knees apparently compensate for the absence of the ACL and do not therefore exhibit quadriceps inhibition. The study also shows the effectiveness of a dynamic brace in stabilizing the tibia against subluxation thus reducing the hamstring’s contraction, and permitting an increase in extension torque in symptomatic knees.⁴⁷

Dynamic bracing is not just limited to the ACL deficient knee. It can be used on the reconstructed ACL to reduce stress on the reconstruction and permit earlier mobilization and quadriceps exercise⁴⁶. The same principles can be used to reduce posterior subluxation for posterior cruciate problems by placing an anterior load on the tibia during knee flexion.

It is possible to use the principles of dynamic bracing to place varus or valgus loads on the knee for problems such as medial and lateral collateral ligaments, tibial plateau fractures, and osteoarthritis. In gonarthrosis it is particularly effective. When a dynamic brace is seen extending on the leg, it is easy to see the brace placing a large valgus load on a knee with medial gonarthrosis. As the leg is extended, the brace uses muscle power to dynamically close the lateral compartment and open the medial compartment of a varus knee with osteoarthritis to control pain.

In a recent preliminary study by Noyes et al⁴⁹, patients that used the Bledsoe Thruster MA Brace for only 3 weeks were able to increase their walking time by a factor of five. They increased their function grade and activity level by 20%- 25%.

At the same time, their average pain level during this increased activity and increased walking time was reduced from an average analog score of 7 to less than 3 (Fig J, K, L).⁴⁹ Most of the patients were able to completely eliminate the need for pain and anti-inflammatory medications. The brace is very helpful in delaying the need for high tibial osteotomy or total knee replacement. The brace can also be used to test the effectiveness of an HTO, or to help hold the HTO closed after surgery thus permitting earlier motion and ambulation. Dynamic bracing is capable of overcoming many of the obstacles that limit traditional passive orthoses, but it is not a cure-all. It is an interesting new tool that can be optimized to provide higher forces to control certain pathological conditions that are not possible to control with conventional designs. It expands the control that a brace can provide. There are many interesting possibilities as we search for ways to use these new principles for other joints and other pathological conditions.

KNEE BRACES

Thruster knee brace

The Thruster remains the best performing OA brace on the market today

Features include:

Dynamic control provides the greatest relief in full extension and relaxes in flexion.
Eliminates pressure points and increases patient compliance.
The only single upright brace proven to provide pain relief.
Patient adjustable dial.

Aligner ESE OA Knee Brace:

Features

Applies the principles of the Thruster with a lower profile hinge design.
Eliminates pressure points and increases patient compliance.
Features a patient adjustable dial.

Indications
For medial or lateral Unicompartmental Osteoarthritis.

Legacy Thruster

Legacy Thruster is a smaller, lighter single-upright model that features an improved hinge but maintains the same overall look. Unlike the competition, the Bledsoe Legacy Thruster's hinge is on the affected side of the knee. This design creates relief by pulling the straps to open the joint space vs. pushing against the opposite side of the knee. This design addresses OA conditions only, not associated ligament instability.

Low-profile frame
Dial allows incremental force adjustments
Hinge is on involved side of knee, pulling vs. pushing to relieve joint pain
Distal calf section flexes with the muscles of the leg
Up to 22 degrees of correction can be applied
For moderate to severe OA patients who require the brace for all-day use
Not for patients with combined instabilities
OK for moderate activities like walking, golf, tennis, bicycling, etc.
Not OK for high-intensity sports like football, basketball, skiing, etc.

DUO (Dynamic Unloading Osteoarthritis) Brace

DUO (Dynamic Unloading Osteoarthritis) Brace is the only double upright "dynamic" OA brace in the market. This brace creates a load across the joint when the knee is straight and reduces the load when the knee is flexed. Thus, when the patient is bearing weight, the brace is actively working. DUO is active when the patient is standing and relieves pressure when sitting.

Low-profile frame
Dynamic loading hinge
Incremental arm adjustments
Available in both custom and off the shelf
Unique strapping prevents migration
Requires the brace for all-day use
OK for patients with redundant tissue
OK for low activity levels like golf, bowling, etc.

Z12 Adjustable Braces

Z12 Adjustable Brace is ideal for patients with an active lifestyle who may need additional support from a dual upright brace due to ligamentous instability. The new adjustable condyle will allow patients to make minor load adjustments by sliding the loading level through 5 settings. The Z12 frame is made of magnesium - our lightest-weight OA brace.

Low-profile frame
Adjustable hinge
Unique upper calf strapping mimmicks a finger-trap design to minimize migration
For specific activities, not all day wear
For patients with combined instability as well as mild-moderate OA
Not recommended for patients with abnormal amount of redundant tissue
OK for activities like basketball, skiing, softball, etc.
Not OK for contact sports like football, rugby, etc.

Functional Knee Ligament Brace

AXIOM-D

Features include:

Same features as the AXIOM-D, but for patients who do not need additional dynamic control.
Unique strapping system maintains brace position.
Maximum strength and impact protection with our spring steel reinforced Aluminum version.
Lightweight Magnesium material available.
All parts can be replaced by the patient using the tools provided.
Longer 16-inch length for maximum control.

Indications
Provides stability and support following injury or reconstruction of the ACL, PCL, MCL, LCL and menisci. Also recommended for prophylactic use.

Anterior drawer leaves patients with a dreadful feeling of instability. By controlling tibial translation, the AXIOM-Dhelps patients regain confidence to golf, ski and enjoy other lifetime sports. Our proprietary Dynamic Tibial Mechanism moves posterior as the leg extends controlling tibial subluxation and that feeling of instability.

Dynamically controls the tibia using our proprietary Dynamic Tibial Mechanism
Unique strapping system maintains brace position
Maximum strength and impact protection with our spring steel reinforced aluminum version
Lightweight magnesium material available Summer 2009
Longer 16-inch length for maximum control

20.50 Patellofemoral

20.50 is the first patellofemoral brace to function in flexion, which is where the pain happens. The Bledsoe 20.50 is also available in a custom version.

Features include:

Functions dynamically - begins to tighten immediately in flexion, with the strongest force between 30 and 40 degrees. The 20.50 relaxes tension past 90 degrees through extension.
Convenient short length, 12 inches (30.5 cm).
Innovative pneumatic Patello-Force strap allows natural patella movement, including tilt and rotation.
Correct high Q-Angle lateral pull.
New Magnesium alloy -- 30% lighter than aluminum
Magnesium frame adds MCL and LCL support.
Adjustable Crescent Finger Pad grips the patella to control Medial Tilt, Patellar Baja and other forces.
Circumferential straps provide firm correction, keeping the patella in the groove.
Cooler than neoprene.
Rigid shell performance counters the force of the quads and resists rotation.
Improves patellofemoral tracking.
Controls patellar subluxation and dislocation.

Lateral Patella Stabilizer - achieves patellar stabilization with a tubular lateral "J" buttress. Lateral-to-medial strapping provides added stability. Durable neoprene material provides support, padding, compression and warmth.

Indications
This device is indicated for patellofemoral disorders including lateral patellar subluxation, dislocations, and lateral patellofemoral malalignment.

Crossover knee brace

Crossover knee brace is designed for very mild meniscal and/or collateral injuries. Patients with minor knee ligament strains and stretches or meniscal damage can benefit from added support to prevent more serious injury. Bledsoe offers several versions of the Crossover to provide the right kind of support for these very mild instabilities.

Features include:

Available in TriTech material for a lightweight, breathable brace with mild compression or 3D Neoprene for warmth and maximum compression support.
Available in three brace styles and two brace lengths
Pull tabs ease application
Mesh popliteal for patient comfort

Indications
For mild ACL, PCL, and MCL sprains, menisci and patellar retinaculum injuries, and mild instabilities.

Tendon Strap- distal to the knee cap and let the unique dogbone buttress ease the tension of chronic inflammation. The Tendon Strap can also be used on the arm, placed distal of the elbow to relieve the pain of Tennis Elbow.

Indications
When used on the knee, indicated for Patella Tendonitis and Chondromalacia. When used on the elbow, indicated for Tennis Elbow, Carpal Tunnel Syndrome and other forms of forearm and wrist pain.

Extender Plus Brace

Extender Plus Brace meets the physicians' needs. Adjustable from 22" to 34" (56 cm to 86 cm) in length and up to 34" (86 cm) in leg circumference, this brace easily fits patients from 5' (152 cm) to 6' 5" (196 cm) tall, and adapts as the patient progresses. The Bledsoe Extender Plus is so versatile there is no need for an expensive custom-fitted brace.

Indications
This device is indicated for immediate application to knees for locked or limited motion control of knee during rehabilitation after operative procedures or injury to knee ligaments (MCL, LCL, ACL and PCL), patellar ligament, articular cartilage, meniscus, or stable or internally fixed fractures of tibial plateau, condyles, proximal tibia or distal femur.

Merit OR Knee Brace frees the surgeon or authorized technician from the time-consuming post-op fitting and application that is required with more complex brace designs. This knee brace provides the same benefits as the Bledsoe OR in a cool, open design for warm climates.

Indications
This device is indicated for locked or limited motion control of knee during rehabilitation after operative procedures or injury to knee ligaments, cartilage, or stable or internally fixed fractures of tibial plateau, condyles, or proximal tibia and distal femur.

Original Knee Brace gives fracture treatment patients maximum support and comfort. The Original, our most adaptable brace, integrates fracture plates as well as shoe inserts, boots and/or pelvic brace for KAFO and/or HKAFO.

Indications
This device is indicated for immediate application to knees for locked or limited motion control of knee during rehabilitation, after operative procedures or injury to knee ligaments, cartilage, or stable or internally fixed fractures of the tibial plateau, condyles, or proximal tibia and distal femur. Also indicated for immediate post-injury application for stable, non-displaced or internally fixed fractures of the middle to distal femur and the proximal to middle tibia or fibula when using the optional fracture bracing plates and shoe insert.

Single Panel Knee Immobilizer

Features include:

One size adjusts from 18” to 26” in half-inch increments
Anti-migration gastroc strap
Quick lock from -10° to 40°
Malleable arms
Full cuff and cool versions

Indications
For sprains and strains of the knee; ACL, PCL, MCL, LCL, and soft tissue injuries where immobilization is needed.

Philippon Post-Op Hip Brace was developed in collaboration with Dr. Marc Philippon, MD, Director of Sports Medicine/Hip Disorders at the University of Pittsburgh. The brace limits hip flexion/extension as well as abduction and adduction in 15° increments from -30° to 105°. The brace can also lock in any position from -30° to 60°. The post-operative or post-injury brace protects patients following total hip revisions, arthroscopic hip repairs or other hip joint surgeries, injuries or problems that can benefit from range-of-motion control.

Indications
This device is indicated for post-operative or post-injury use for limited range-of-motion control of hip flexion/ extension; as well as limited abduction and adduction of the hip joint following total hip revisions, arthroscopic hip repairs or other hip joint surgeries, injuries or problems that can benefit from range-of-motion control.

Simple Pelvic Brace is the solution to the difficult problem of hip rotational control. This off-the-shelf brace fits like a custom and can be applied in less than 10 minutes. The Bledsoe Simple Pelvic Brace limits hip flexion/ extension as well as abduction and adduction in 15° increments from -30° to 105° and locks in any position from -30° to 60°.

Indications
This device is indicated to limit motion and reduce incidence of dislocation of the hip and to provide limited motion of hip abduction or adduction after injury or operative procedures to the hip joint.

Achilles Boot saves time by eliminating casting series required to stretch the achilles tendon during rehab.

Off-the-Shelf Ankle Brace

Axiom Ankle Brace offers staunch protection to an injured ankle. Also available in a custom version.

Indications
This device is designed to increase support in the inversion and eversion control of unstable ankles, and indicated for increased inversion and eversion control for grade 1 and 2 acutely sprained ankles where dorsi-flexion and plantar-flexion is permissible and inflammation is under control.

SideKick Ankle Brace is a single upright functional ankle brace unlike any ankle brace or support on the market. Made of aerospace super alloy aluminum, the SideKick features control for chronic ankle instabilities or early rehabilitation of acute ankle sprains where ankle plantar-flexion and dorsiflexion is permissible.

Wraptor Ankle Stabilizer prevents eversion or inversion by supporting the ankle in a biomechanically neutral position using non-stretch nylon figure-eight straps. The Wraptor is effective protecting the ankle either proactively or in the rehabilitation of acute ankle sprains. Fits both the right and left ankle. Also available with Speed Laces for quick application and removal.

M-Brace Ankle Support reduces ankle swelling while boosting the patient's confidence when its time to get back in the game. The M-Brace is available in two models — the Air M-Brace or the Air-Gel M-Brace, and are conveniently one size and a universal style.

This device is indicated for immediate application to ankles for mild sprains.

Plantar Fasciitis Support provides continuous elastic tension and pressure to reduce the pain associated with inflammation due to plantar fasciitis. Used in conjunction with Bledsoe's recommended exercise program, the PFS reduces pain, allowing the patient to strengthen the muscles of the foot, arch and lower leg, as well as stretch the Achilles tendon to provide relief and prevent future discomfort from plantar fasciitis.

ARC with Pillow

Features include:

One brace fits all size patients and is universal, right and left
Traditional pillow design
Perforated cool version available

Indications
For non-surgical or post-operative support and immobilization of the injured shoulder where glenohumeral positioning is key.

T-Chek BRACE

For non-surgical or post-operative support and immobilization of the injured shoulder where glenohumeral positioning is key.

Indications

For immediate application following injury or operative procedures to the elbow, or for stable fractures of the distal humerus or proximal to middle radius or ulna.

Clavicle Support immobilizes the clavicle. It features urethane foam contoured for fit and comfort; fully adjustable, easy-touch closures; rear buckles for easy tension adjustment; and five available sizes to provide an optimal fit for any patient.

Indications
Ideal for clavicular fractures and posture correction.

Clinic Arm Sling features: Five sizes for better fit; over-sized envelope to accommodate large casts and dressings; thumb loop to keep the sling in position; customized fitting and adjustment features on front and back for perfect fit; padded strap with easy-touch closure; and is Latex-free.

Indications
Immobilizes and supports mild sprains and strains of the shoulder or fractures of the arm.

Sling & Swathe Immobilizer features: Lightweight, soft foam support; adjustable slide buckle straps; universal fit to reduce inventory; easy-touch closure; and is Latex-free.

Indications
Immobilization for sprains, strains and fractures. Swathe firmly secures arm against body or fixates shoulder. Contraindicated for unstable fractures.

Telescoping Elbow Brace is designed to handle post-op elbow arthroscopy, severe elbow strains and ligament trauma. The Bledsoe Telescoping Elbow Brace should be used when limited R.O.M. or locked control of the elbow is desired. In most cases, the Bledsoe Telescoping Elbow Brace can be formed, fitted and adjusted in 5 minutes or less.

This device is indicated for immediate application following injury or operative procedures to the elbow, or for stable or internally fixed fractures of the distal humerus or proximal to middle radius or ulna where locked or limited motion control of the elbow is desired.

CTS Wrist Lacer utilizes malleable palmer stays to provide customized angulations and a thumb cut-out to improve patient manipulation, movement and compliance. Durable yet supple suede with perforations provide for greater comfort.

Indications
Immobilization and support for Carpal Tunnel Syndrome, wrist sprains & strains, and rehab and post-cast support.

Wrist Lacer with Thumb Spica utilizes malleable palmer stays to provide customized positioning and covers the extensor surface of the thumb. Durable yet supple suede with perforations provide for cool comfort.

Indications
For support and symptomatic relief of Gamekeeper's Thumb, deQuervain's Syndrome, scaphold injury, Carpel Tunnel, and sprains and strains.

SPINAL ORTHOSIS

Volare with Chairback features:

Anterior and Posterior panels to unload spinal pressure for pain relief.
Zip Line that provides a 5:1 mechanical advantage for easy one hand adjustment.
Posterior chairback panel that extends from sacrococcygeal junction to T-9 vertebra.
Anterior, posterior and lateral control.

Indications
Mechanical Back Pain, Posterior Lateral Fusion, Lumbar Spinal Laminectomy, multiple level decompression, Spondylolisthesis, and Spinal Stenosis

LumboLux

Features:

Elastic construction eases back pain with lumbar support while promoting proper range-of-motion
Compound closure with two-stage compression
Moldable and removable anterior and posterior panels
15° lordosis built-in

Indications
For chronic back pain, discogenic disc disease, lumbar muscle or ligament sprain or strain, spondylolithesis, spondylolysis, and when disc pressure unloading is desired.

Ninja PRO

Features:

Rigid anterior panel and thoracic chairback frame unload spinal pressure for pain relief
Posterior panel extends from sacrococcygeal junction to T-9 vertebra
Optional Extender Chest Piece
Available in low or standard profile
Quick pull provides 6:1 leverage for easy one-hand adjustment

Indications
Mechanical back pain, posterior lateral fusion, lumbar spinal laminectomy, multiple level decompression, spondylolysis, spondylolisthesis, spinal stenosis