• Universal design allows for inventory reduction; features contoured posterior stays and movable medial/ lateral stay assemblies for optimal positioning and immobilization with 4” elastic patella strap for added compression.
  • Indicated for post-op knee immobilization and mild to severe knee injuries where full extension of the leg is desired.
  • Constructed of breathable foam laminate to soft loop pile with hook and loop closure straps, premium quality elastic straps and aluminum stays.

HCPCS Code: L1830

PDAC Letter

Product Number 6″L 9″L 12″L 14″L
Univ 51-1506 51-1509 51-1512 51-1514
16″L 18″L 20″L 22″L 24″L
Univ 51-1516 51-1518 51-1520 51-1522 51-1524
X-Wide 92-5116 92-5118 92-5120 92-5122 92-5124
Sizing Guide 6″L 9″L 10 1/2″L 12″L 14″L
Univ 11″ 14″ 15 1/2″ 20″ 20″
X-Wide 25″ 25″
16″L 18″L 20″L 22″L 24″L
Univ 24″ 24″ 25″ 25″ 27″
X-Wide 29″ 29″ 30″ 30″ 32″
Measurement taken from leg circumference 4” above mid-patella.

Remove any metal stays if possible.
Close all contact closures and hand wash in warm water with mild soap.
Product should be air-dried.
Do not use high temperatures to wash or dry.

  1. Open knee immobilizer and remove stay assemblies.
  2. Position knee immobilizer so patella strap will go over the mid-line of the patella with wide end toward thigh and back stays along midline of leg.
  3. Use small hook tab to hold body around knee.
  4. Attach stay assemblies, inside first, to accommodate calf and thigh circumference.
  5. Starting at the bottom and moving up, thread straps through buckles and pull back, attaching straps where comfortable.
  6. Pull patella strap across knee and attach.