No benefit of bracing on the early outcome after anterior cruciate ligament reconstruction

Abstract

Forty patients were prospectively investigated to evaluate the effects of bandaging after reconstructive surgery of the anterior cruciate ligament (ACL). For the 6 weeks of the postoperative course, the operated knee was bandaged in 20 patients (group A) and braced in the other 20 patients (group B). The isokinetic torque for extension and flexion (Cybex) and the range of motion (ROM) were investigated after 6, 12, 24 and 52 weeks postoperatively. At 24 weeks and 1 year postoperatively the stability of the knee joint (KT-1000) as well as the clinical outcome ('Orthopädische Arbeitsgemeinschaft Knie') were evaluated. No statistically significant differences between the two groups were found for the extension and flexion strengths. Free ROM was achieved significantly earlier in group A than in group B. No statistically significant differences regarding the stability of the operated knee joint nor the early outcome were found between the two groups. This study demonstrated that the renunciation of using a brace had no adverse effect on the early outcome with respect to stability and function. On the contrary, bracing seems not to be mandatory after ACL reconstruction when the central third of the patellar tendon is used.

Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play

“…The quality assessment revealed that 19 studies inadequately described the source population,13 44–61 18 studies inadequately reported the preinjury sports participation level of participants,5 12 13 26 46 51 54 57 61–70 and 18 studies failed to report the number of participants returning to their preinjury level of sports participation 5 26 44 46 49 55 57 61 62 64 66–73…”

“…Seventeen studies reported mean anterior tibial translation,5 13 44 48 52 55 56 59–61 68 71 73 74 77–79 with a combined group mean of 1.7 mm side-to-side difference. When the results of the other 20 studies10 45–48 50 51 54 58 62–65 69 70 80–84 were pooled, it was found that 91% of patients had a side-to-side difference in anterior tibial translation of ≤5 mm at final follow-up. Fifteen studies evaluated quadriceps and hamstring strength at final follow-up 13 44 47–49 53–55 60 62 68 70 72 81 83.…”

Effect of Early Elbow Crutch Mobility on Patients with Post-Anterior Cruciate Ligament Repair

“…Current study also used elastic bandages, during gait training, which could support the early mobilization with single elbow crutch. [13] A study reported that patients mobilized immediately after ACL reconstruction with the help of elbow crutch for 3 weeks and its result also showed there were no difference between the brace group and no brace group. Also the Lysholm Knee Score and the Tegner Score were improved than the brace group.…”

“…[4,13] There is still a lot of controversy concerning the use of braces in rehabilitation following ACL reconstruction. According to surveys in Germany, Australia, and the US, 56.2-85% of surgeons post-operatively prescribe a hard brace.…”

“…According to surveys in Germany, Australia, and the US, 56.2-85% of surgeons post-operatively prescribe a hard brace. [14] Some provide their patients with soft braces or bandages, [13] whereas other surgeons believe bracing to be unnecessary or, in certain cases, even harmful. [15] There are some studies that admit that the protective value ceases as soon as the stress on the joint is increased.…”