Custom Knee Braces: Össur Unloader vs DonJoy Defiance

Knee pain is one of the most common reasons patients come to see us — and one of the most common questions I get is whether a custom knee brace could help. The right brace (custom or not) depends on several factors: age, activity level, the type of knee injury/pain, etc.

I’ve been fitting custom knee braces for over 24 years, and in this guide, I’ll break down two of the leading options we fit at the clinic: the Össur Unloader and the DonJoy Defiance.

Why Custom Bracing Beats Off-the-Shelf

Generic off-the-shelf knee braces are built to fit everyone, which means they fit no one perfectly. A custom brace is measured and manufactured specifically for your leg — your anatomy, your injury, your activity level. That means:

• Better load distribution and reduced pain during movement
• A secure fit that doesn’t slip during exercise or sport
• More targeted support where your knee actually needs it
• A faster, more confident return to the activities you love

Note: Insurance companies will cover custom but not off-the-shelf braces

Best Exercises for Shin Splints (and Injury Prevention)

We’ve put together a short video showing how each brace works and what sets them apart.

Option 1: Össur Unloader — Built for Osteoarthritis and Meniscus Tears

If you’re dealing with arthritis or a meniscus tear, the Össur Unloader is often my first recommendation.

It works using a clinically proven 3-Point Leverage System that physically shifts load away from the damaged compartment of your knee — giving you real, measurable pain relief without surgery.

It’s lightweight, low-profile, and fits under most clothing. Patients notice a meaningful difference within the first few weeks of consistent wear, often delaying or even avoiding knee replacement surgery, and being able to walk much longer or play golf/tennis without pain.

Best suited for:

• Unicompartmental knee osteoarthritis (one-sided arthritis)
• Meniscus tears
• Cartilage injuries
• Post-operative recovery from knee repair
• Patients looking to delay or avoid surgery

Option 2: DonJoy Defiance — Built for Ligament Injuries and Return to Sport

The DonJoy Defiance is the gold standard for ligament instability.

Constructed from hollow carbon fiber, it’s strong but surprisingly light, and uses a 4-Points-of-Leverage System to protect the knee during cutting, pivoting, jumping, and other high-demand movements.

Whether you’re an elite athlete or someone who just wants to get back to hiking or recreational sports, the Defiance gives you the confidence to move freely without worrying about your knee giving way.

Best suited for:

• ACL and PCL tears or reconstruction
• Combined ligament injuries 
• MCL and LCL instability
• Meniscus tears with associated instability
• Athletes returning to high-impact sport

How Do They Compare?

	Össur Unloader	DonJoy Defiance
Primary Purpose	Osteoarthritis and meniscus pain relief	Ligament stabilization
Best For	Arthritis, cartilage damage, and meniscal injuries	ACL, PCL, and multi-ligament injuries
How It Works	Offloads pressure from the damaged side of the knee	Reduces instability during movement
Activity Level	Walking and lower-impact activities	High-impact sports and return to play
Profile	Lightweight and low-profile	More robust, sport-grade protection
Main Goal	Pain relief and joint preservation	Stability and joint protection

How Leaside Sports Medicine Can Help

If you’re dealing with knee pain, instability, arthritis, or recovering from an injury, a custom knee brace may help you move more comfortably and confidently.

To discuss whether a custom brace is the right fit for you, book an assessment with Dr. Joe Kottoor.

Looking for other treatment options? You can also book with any member of the team at Leaside Sports Medicine through the clinic’s Jane App booking page.