Dynamic patellar brace: a new orthosis in the management of patellofemoral disorders. A preliminary report

Abstract

The diagnosis and treatment of patellofemoral dysfunction, especially subluxation of the patella, remains controversial. Many authors feel conservative treatment will give better long-term results than operative treatment. To aid in nonoperative treatment of patellofemoral conditions a dynamic patellar stabilizing brace has been developed. The brace applies an active, medially displacing force to the lateral border of the patella and maintains constant pressure during flexion, extension, and rotation of the knee. This brace consists of an elastic sleeve with a patellar cutout and two circumferentially wrapped "live" rubber arms which apply dynamic tension to a crescent-shaped lateral patellar pad. An elastic circumferential counterarm maintains proper positioning of the pad and prevents rotation of the brace. The brace, superior to other methods of patellar splinting, is felt to be useful in the diagnosis of suspected subluxation in patients without the classical stigmata of patellofemoral dysplasia. It has proven useful in the treatment of 39 cases of patellar subluxation and 4 of patellofemoral arthritis. In a number of cases symptoms were completely eliminated with prolonged use of the brace. The brace is felt to be beneficial in conjunction with vastus medialis rehabilitation in patellar subluxation in growing children; in patients with mild or occasional subluxation, especially during specific activities; in persons with dislocation or subluxation in which surgery is contraindicated or must be delayed; and in acute subluxation. The brace may also be helpful in the prevention and treatment of chondromalacia and patellar tendinitis.