Functional Bracing After Anterior Cruciate Ligament Reconstruction: A Systematic Review

Lowe, Walter R.; Warth, Ryan J.; Davis, Elizabeth; Bailey, Lane

doi:10.5435/jaaos-d-15-00710

Cited by 45 publications

(32 citation statements)

References 39 publications

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“…Altered contralateral hip strategy with limited motion and attenuating forces about the injured knee during gait has been noted in those who did not pass return to sport testing at 6 months [36]. Functional knee bracing may have some benefit via in vivo knee kinematics after ACL reconstruction; however, there is limited evidence that functional knee bracing decreases the rate of re-injury based on a systemic review of 15 studies [37].…”

Section: Late Post-operative Complicationsmentioning

confidence: 99%

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Eckenrode

Carey

Sennett

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of Review The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery. Recent Findings ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissuehealing time frame. Given the evolution of ACL surgical reconstruction techniques and rehabilitation protocols, the risk of post-operative complications can arise both early and late in the recovery process. This paper will discuss the role of preventative measures as it applies to the post-operative patient with ACL reconstruction. Summary Short-term complications following ACL reconstruction include infection and deficits to knee motion and strength, whereas long-term complications include secondary ACL injury to either the involved or contralateral knee and lack of ability to return to high-level sports following this procedure. Future research should continue to address the multifactorial causes of secondary ACL injury and limited ability of patients to return to high level activities.

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Section: Late Post-operative Complicationsmentioning

confidence: 99%

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Eckenrode

Carey

Sennett

et al. 2017

Curr Rev Musculoskelet Med

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“…This finding confirmed the previous literature that showed no advantage of a postoperative treatment with a stabilizing knee brace after ACLR. 10 11 12 13 14 15 18 However, when we analyzed separately the patients who had concomitant surgery (ACLR-OI group), no differences were found in IKDC score between the braced and unbraced subjects.…”

Section: Discussionmentioning

confidence: 89%

“…However, disadvantages of bracing have been claimed, including the potential muscle atrophy, loss of knee extension at the removal, decreased patient's perception of maximal performance, increased fatigability during exercise, and additional costs. 12 13 14 15 18 Unfortunately, no evidence exists on effectiveness of bracing in patients with ACLR and concomitant surgery, 18 and this issue needs to be confirmed by further research.…”

Section: Discussionmentioning

confidence: 99%

Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

Miceli

Marambio

Zati

et al. 2017

Joints

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Purpose The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups. Subjective IKDC score was obtained at follow-up. Statistical analysis was performed to compare the two groups for IKDC score. Subgroup analysis was performed to assess the effect of postoperative regimen (knee bracing and weight bearing) on functional outcomes. Results The mean age of patients was 30.8 ± 10.6 years. Mean IKDC score was 87.4 ± 13.9. The mean follow-up was 3.5 ± 1.8 years. Twenty-two (53.7%) patients underwent ACLR only, while 19 (46.3%) also received other interventions, such as meniscal repair and/or collateral ligament suture. Analysis of overall data showed no differences between the groups for IKDC score. Patients in the ACLR group exhibited a significantly better IKDC score when no brace and full weight bearing after 4 weeks from surgery was prescribed in comparison with patients who worn a brace and had delayed full weight bearing. No differences were found with respect to the use of brace and postoperative weight bearing regimen in the ACLR-OI group. Conclusion Brace and delayed weight bearing after ACLR have a negative influence on long-term functional outcomes. Further research is required to explore possible differences in the patients operated on ACLR and other intervention with respect to the use of a brace and the timing of full weight bearing to identify optimal recovery strategies. Level of Evidence Level III, retrospective observational study.

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“…When the outcome variable focuses exclusively on injury prevention several studies reported increased (29-31) rather than decreased knee injury rates and one specifically mentioned fear of decreased performance adversely influencing brace use compliance (32). For functional knee brace use post-ACL reconstruction, several studies have supported their potentially positive influences on knee kinematics, particularly lower leg rotational control (33)(34)(35)(36), while others have supported their use for improving hop distance symmetry, but not landing mechanics symmetry (37). Their use, however, does not appear to improve clinical outcomes (38,39).…”

Section: Resultsmentioning

confidence: 99%

Distal Thigh Compression Garment Improves Female Athlete Knee Control and Sports Movement Safety Perceptions

Boschert

Nyland

Matsuno

et al. 2020

Muscle Ligaments and Tendons J

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Introduction. This study measured knee frontal plane projection angle (FPPA) and sports safety and performance perceptions of female athletes during a single leg forward hop down and stabilization (SLFHS) for 3 conditions (standard knee sleeve, no device and distal thigh compression garment (DTCG)). The hypothesis was that the DTCG group would display superior dynamic knee valgus FPPA compared to the standard knee sleeve and no device groups. Methods. Eighteen healthy college athletes participated in this prospective cohort study with a randomized device order. FPPA was measured during SLFHS using two-dimensional biomechanical techniques to estimate dynamic knee valgus loading. A 10-cm visual analog scale survey collected data regarding subject perceived knee control, sports movement capability and overall satisfaction for each condition. Pearson correlations delineated knee valgus, safety and performance relationship perceptions (p < 0.05). Results. Mean/maximum dynamic knee valgus FPPA was lowest during the DTCG condition (8.7 ± 6°/12.2 ± 7°), or a 19.4%/21.3% range of motion reduction compared to the standard knee sleeve (10.8 ± 7°/15.5 ± 8°) and a 21.6%/17% reduction compared to the no device (11.1 ± 7°/14.7 ± 7°) conditions. Chi-square tests revealed that the T:25 group displayed a greater proportion of subjects with a "1" score (≤threshold value) than the standard knee brace or no device groups for both mean (one-sided p value = 0.02) and maximal (one-side p value = 0.049 FPPA). In relationship to maximum dynamic knee valgus FPPA, the DTCG was the best overall condition (r = 0.61, p = 0.007), relating more strongly to perceived knee control (r = 0.63, p = 0.005) and sports movement capability (r = 0.64, p = 0.004). Conclusions. Compared to standard knee sleeve and no knee device conditions, the T:25 device provided better dynamic knee valgus FPPA control and stronger subject perceptions of best overall condition, knee control and sports movement capability.

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Functional Bracing After Anterior Cruciate Ligament Reconstruction: A Systematic Review

Cited by 45 publications

References 39 publications

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

Distal Thigh Compression Garment Improves Female Athlete Knee Control and Sports Movement Safety Perceptions

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