Can a knee brace reduce the strain in the anterior cruciate ligament? A study using combined in vivo/in vitro method

Hangalur, Gajendra; Brenneman, Elora C.; Nicholls, Micah; Bakker, Ryan; Laing, Andrew C.; Chandrashekar, Naveen

doi:10.1177/0309364615574167

Cited by 23 publications

(52 citation statements)

References 13 publications

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“…A study with an altogether different approach evaluated the effect of a PKB during dynamic activities such as drop-landing in a high risk subject (12). They compared ACL strain in braced and unbraced conditions, showing that wearing the knee brace resulted in a 55% reduction in peak ACL strain.…”

Section: Biomechanical Effects Of Bracingmentioning

confidence: 99%

“…They compared ACL strain in braced and unbraced conditions, showing that wearing the knee brace resulted in a 55% reduction in peak ACL strain. However, according to the authors, the reduction was a result of altered muscle-firing pattern due to the presence of the brace, rather than its mechanical effect, potentially reducing ACL injury risk (12).…”

Section: Biomechanical Effects Of Bracingmentioning

confidence: 99%

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Do Knee Braces Prevent Ski Knee Injuries?

2017

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Background: Alpine skiing has high rates of knee injuries. Prophylactic knee braces (PKBs) and functional knee braces (FKBs) are often prescribed by clinicians to reduce injuries or re-injuries in skiers. Objectives: This literature review evaluates current knowledge on the biomechanical and clinical effectiveness of prophylactic and functional knee braces in preventing knee injuries and their impact on the athletic performance of non-injured and injured individuals. Methods: A literature review was performed to analyze the efficiency of knee braces concerning the reduction of mechanical stress, influence on muscle control, performance and injury prevention. Results: Most of the available literature describes research on the use of knee braces in contact sports, specifically American football. In this context, several studies show braces to be more effective in preventing medial collateral ligament injuries than anterior cruciate ligament injuries in both cadaveric and clinical studies. The use of functional braces after anterior cruciate ligament reconstruction has been supported and refuted in both postoperative and long-term studies. Ski-specific studies show a positive effect of knee braces on proprioception; no influence on performance; and a protective effect on previously injured skiers. Conclusions: Current literature indicates PKBs may have a protective function in healthy patients, while influence on performance is minimal. Functional braces are recommended in ACL-deficient patients and are biomechanically effective under low-loading conditions. They may not be as effective in high-loading conditions, such as athletic activity. There is a protective effect of FKBs of preventing re-rupture of reconstructed ACLs and preventing further knee injuries on ACL-deficient knees in skiers. More research is needed to determine the effectiveness of PKBs snow sports.

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Section: Biomechanical Effects Of Bracingmentioning

confidence: 99%

Section: Biomechanical Effects Of Bracingmentioning

confidence: 99%

Do Knee Braces Prevent Ski Knee Injuries?

2017

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“…Whereas operative treatment aims to reduce laxity, non-operative treatments aim to reduce functional instability and both thereby prevent further damage to the menisci and cartilage, which may contribute to post-traumatic osteoarthritis [ 58 , 84 ]. Functional bracing, intended to reduce the risk of ACL injury by decreasing peak ligament strain, has not yet been conclusively shown to achieve this goal, as the evidence is still limited [ 29 , 75 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group

Diermeier

Rothrauff

Engebretsen

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative vs. non-operative treatment for ACL injury. The purpose of this study is to report the consensus statements on operative vs. non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, were convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organizing Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided the initial agreement and comments on the statement via an online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty percent agreement was defined a-priori as consensus. A total of 11 of 13 statements on operative v. non-operative treatment of ACL injury reached the consensus during the Symposium. Nine statements achieved unanimous support, two reached strong consensus, one did not achieve consensus, and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatments with patients after an ACL injury. Level of evidence V.

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“…The RC brace is designed to apply a larger valgus moment than the UF brace. A combined in vivo, in silico and in vitro dynamic approach developed by previous works [23][24][25][26] is used in this study to investigate three activities of typical daily living including a two-legged squat (2LS), one-legged squat (1LS) and walk (WLK). This study hypothesizes the following: i. Unloader knee braces decrease the strain in the medial meniscus during dynamic activities.…”

Section: Introductionmentioning

confidence: 99%

The effect of unloader knee braces on medial meniscal strain

Kalra

Bakker

Tomescu

et al. 2019

Prosthetics &Amp; Orthotics International

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Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees. Clinical relevance Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.

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Can a knee brace reduce the strain in the anterior cruciate ligament? A study using combined in vivo/in vitro method

Abstract: Prophylactic knee brace could reduce the strain in the anterior cruciate ligament of high-risk subjects during drop-landing through altered muscle firing pattern associated with brace wear. This could help reduce the anterior cruciate ligament injury risk.

Cited by 23 publications

References 13 publications

Do Knee Braces Prevent Ski Knee Injuries?

Do Knee Braces Prevent Ski Knee Injuries?

Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group

The effect of unloader knee braces on medial meniscal strain

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