ORLANDO, Fla. – In 2006 Frost and Sullivan looked at the brace and support industry and said that osteoarthritis (OA) braces were the fastest growing segment of the brace market. According to a sales representative here, that is not a surprise.
“We know the baby boomers are in their arthritis years, they are more active than previous older generations, they are heavier, their knees take a pounding and their numbers are going to continue to swell for a few more years. So, that is why Frost and Sullivan predicted there would be this surge in the knee brace business,” Thomas McGovern, co-owner of Heritage Medical said here at the 2010 American Orthotic and Prosthetic Association’s National Assembly. “I’ve been doing this for 15 years. I keep looking for this surge but I am not seeing it.”
McGovern explained that four million Americans are estimated to suffer from knee OA.
“I would ask practitioners, “Where are all of your prescriptions for OA braces?’” he said. “The answers I usually got were these: stock and bill; orthopedic practices are opening in-house bracing departments; manufacturers are sending their sales reps in; and reimbursement. All those reasons are valid, but what I want to stress is that those reasons are scraps from the table. When it comes to the money spent on OA bracing, I really want to talk about modality awareness. Do your doctors know that bracing the arthritic knee is an effective treatment option? I’d say no. Out of all the money spent on OA every year, half of 1% … goes to bracing. So where is all the rest of that pie going?”
McGovern went on to explain that the drug market is taking over the majority of the patient population and provided some additional evidence as to why knee braces have taken a backseat to other treatments.
In 2004, the American Academy of Orthopaedic Surgeons (AAOS) released a position statement in support of knee braces for the treatment of knee OA.
“What they came up with is that these braces will increase function and decrease pain. That is the heart of their position statement,” McGovern said.
In 2008, AAOS released their knee OA treatment guidelines which looked at 22 different treatment options. The organization stated that they could not recommend either for or against the use of knee braces for the treatment of knee OA. According to McGovern, this wavering decision was based on limited research. McGovern investigated the real reason behind the AAOS change of opinion and found that it rests in a lack of attention.
In independent conversations with three of the thought leaders behind the statements, McGovern found that even they did not agree with the final decision. Additionally, he reviewed the literature between this 4-year gap, of which most articles, specifically in the Journal of Bone and Joint Surgery, pointed to agree with the conclusion reached in 2004.
With the side effects of health care reform still to be felt, McGovern encouraged clinicians to beware of the increasing use of oral medications to treat knee OA and to educate their referral sources about the benefits of bracing.