OTS vs. Custom Ascender Knee Brace

Are you ready to take the next step forward in getting your Ascender knee brace, but having trouble deciding which one is best for you? Let’s look at the difference between the two versions of the Ascender and break down why you may choose one over the other. 

Custom-Fabricated Ascender Knee Brace

Have you had trouble with past knee braces sliding down your leg? If you’re looking for a brace that is perfectly contoured to your leg, comfortable, and maximizes pain reduction, look no further than the custom-fabricated Ascender. 

From the comfort of your own home, you can download the Icarus Medical app on your iPhone and capture a rapid scan of your leg, generating a highly-detailed 3D leg model. Your personal engineer will open your leg model and import a 3D model of the brace. Then, they will adjust every line of the brace so it fits your leg like a glove.

icarus knee brace

Figure 1. Scan-to-3D Print Technology

Anybody with an iPhone X or newer can download the Icarus Medical app and follow our scanning instructions to quickly submit a leg scan. Once we have the scan, your engineer models a sleek, form-fitting brace made to meet the needs of each individual patient. Within the hour, your brace is sent to print, and about 2 weeks later, gets delivered!

Modelling our braces custom to each individual also gives us the opportunity to meet your clinical needs to the best of our ability. Is your arthritis worse on the inner (medial) part of the knee than it is on the outer (lateral) part? If so, the engineers can model additional unloading into the medial compartment utilizing a 3-point pressure system. 

Within one hour of opening your scan, your engineer has your brace modeled, passed through quality assurance checkpoints, and sent to be 3D printed. Your personalized knee brace will be delivered 10-12 business days after the order is finalized.

Custom Fit (Off-The-Shelf) Ascender Knee Brace

Our off-the-shelf (OTS) braces offer a more economically favorable solution to your knee pain with an even faster estimated delivery time!

Using three circumference measurements of your leg or a leg scan submitted through our Icarus Medical app, we size your leg into one of the standard size ranges (XS-XL). 

icarus chart

Figure 2. Off-the-Shelf Size Ranges

Circumference measurements should be taken 6” above knee center, at knee center, and 6” below knee center. Clinicians may choose to include medial-lateral knee caliper measurements.

Once we have your brace sized into one of our size ranges and have all of the documents needed to move forward, we’ll get your order placed. You can expect your OTS Ascender to arrive within 2-3 business days of the order being finalized.

Which is Best for You?

First and foremost, we always recommend using insurance when possible to keep the cost to a minimum and to ensure the brace is discussed with your clinician(s). Clinicians will assess your anatomy and clinical history to decide which version of the brace to prescribe.

For those of you who are not using insurance, or are interested in learning more, let’s talk through some reasons one brace may be more advantageous to you than the other. 

Quadriceps “Q” Angle

Most of us have heard the phrases “knock-kneed” or “bow-legged” used when describing a person’s leg structure. The Q Angle describes the angle from the peak of your hip to your knee center, then straight down your shin bone (tibia). 

icarus diagram image

A person who is “Knock-kneed”, clinically defined as “valgus”, has one or both knees closer to the other than “normal”. Someone who is “bow-legged” or “varus” will have one or both knees further from one another than normal. The Q Angle is often an important factor in understanding what’s causing your knee pain.

Figure 3. The Q Angle and Varus/Valgus Leg Deformities

We make our braces based on standard Q angles, but deviations from the “norm” should be factored in when considering a custom versus an OTS brace. 

While we often factor medial/ lateral adjustments into the model of the brace, we are also able to offer a less-permanent solution by including a shim kit. For patients who only need slight adjustment, we can include a few additional condyle pads – the two round pads on the brace where the hinges meet the inner and outer sides of the knee – which can be stacked to “shim” the desired degree of adjustment.

Outside of OTS Size Ranges?

Your leg measurements may place you in larger or smaller size ranges than we carry in OTS sizes, or may place you in multiple size ranges. For patients who don’t fall into one standard size range, a custom knee brace is highly recommended over the off-the-shelf.

Brace Costs

We estimate that over 95% of patients wearing the Ascender have been covered by insurance or the VA, allowing us to keep patients’ out-of-pocket costs down. After insurance, the average cost to our patients is between $100 and $200. For VA-established veterans, the VA covers both versions of the brace at 100%.

Some patients choose to skip insurance altogether to speed the process along. The MSRP of the OTS brace is less expensive than that of the custom brace. In cases where patients are paying in full or insurance coverage varies, the OTS can offer a financial advantage over the custom. No matter the brace type or whether insurance is used, all of our Ascender knee braces are covered under our warranty and include the same 30-day money-back guarantee.




Delivery time

2-3 business days

10-12 business days


<13 ounces

<13 ounces

Medial/ Lateral Adjustment

Shim Kits

Additional unloading modeled into the brace frame

Shim Kits

MSRP – No Insurance





3-D Scan to Model Fit

Table 1. Factors in Determining Off-the-Shelf and Custom Ascender Knee Brace

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Most braces are covered by insurance and the average cost is under $200!

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