Literature DB >> 23807029

Brace or no-brace after ACL graft? Four-year results of a prospective clinical trial.

Hermann O Mayr1, Paul Stüeken, Ernst-Otto Münch, Morris Wolter, Anke Bernstein, Norbert P Suedkamp, Amelie Stoehr.   

Abstract

PURPOSE: A controversial discussion is held on using stabilizing knee braces after anterior cruciate ligament (ACL) surgery. The current study investigated the influence of a stabilizing knee brace on results after ACL reconstruction using patellar tendon autografts.
METHODS: A prospective randomized study was started including 64 patients divided into two equal groups and treated with or without a stabilizing knee brace for 6 weeks post-operatively. A follow-up examination 4 years after operation comprised IKDC 2000, KT1000 measurement, a visual analogue pain scale (VAS; scores 0-10) and radiographic evaluation. The t test for independent and paired samples and the Pearson's Chi-square test were used for statistical analysis (p < 0.05). The primary endpoint was the difference in IKDC classification.
RESULTS: Eighty-one per cent of the patients were examined 4 years post-operatively. IKDC 2000 subjective (brace group 90.5 ± 8.9, braceless group 93.2 ± 6.1) and objective results (brace A 30%, B 56%, C 16%; braceless A 32%, B 48%, C 20%) and instrumental measurement of anteroposterior laxity with KT1000 (brace 0.6 ± 2.4 mm, braceless 1.8 ± 3.4 mm) showed no significant differences. VAS pain results were significantly better in the braceless group at 1.0 ± 1.2 versus 1.9 ± 1.4 under sports activity or heavy physical work (p = 0.015). There were no radiographic differences concerning osteoarthritic findings and tunnel widening between the groups.
CONCLUSION: Post-operative treatment with a stabilizing knee brace after ACL replacement showed no advantage over treatment without a brace at 4-year follow-up. The use of a knee-stabilizing brace after isolated ACL reconstruction with autologous patellar tendon graft is not recommended. LEVEL OF EVIDENCE: II.

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Mesh:

Year:  2013        PMID: 23807029     DOI: 10.1007/s00167-013-2564-2

Source DB:  PubMed          Journal:  Knee Surg Sports Traumatol Arthrosc        ISSN: 0942-2056            Impact factor:   4.342


  37 in total

1.  Arthrofibrosis following ACL reconstruction--reasons and outcome.

Authors:  Hermann O Mayr; Thomas G Weig; Wolfgang Plitz
Journal:  Arch Orthop Trauma Surg       Date:  2004-08-03       Impact factor: 3.067

2.  Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries.

Authors:  G Németh; M Lamontagne; K S Tho; E Eriksson
Journal:  Am J Sports Med       Date:  1997 Sep-Oct       Impact factor: 6.202

3.  Use of an extension-assisting brace following anterior cruciate ligament reconstruction.

Authors:  J Feller; J Bartlett; S Chapman; M Delahunt
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  1997       Impact factor: 4.342

4.  Effect of brace design on patients with ACL-ruptures.

Authors:  G Strutzenberger; M Braig; S Sell; K Boes; H Schwameder
Journal:  Int J Sports Med       Date:  2012-06-15       Impact factor: 3.118

5.  Rating systems in the evaluation of knee ligament injuries.

Authors:  Y Tegner; J Lysholm
Journal:  Clin Orthop Relat Res       Date:  1985-09       Impact factor: 4.176

6.  Arthroscopically assisted reconstruction of the anterior cruciate ligament. A follow-up report.

Authors:  D B O'Neill
Journal:  J Bone Joint Surg Am       Date:  2001-09       Impact factor: 5.284

7.  Sensitivity to changes over time for the IKDC form, the Lysholm score, and the Cincinnati knee score. A prospective study of 120 ACL reconstructed patients with a 2-year follow-up.

Authors:  M A Risberg; I Holm; H Steen; B D Beynnon
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  1999       Impact factor: 4.342

8.  [Mass sports improves proprioception and reduces valgus stress on the female knee joint].

Authors:  S Lippross; G Prange; K Oehlert; O Katharina; O Furkmann; A Seekamp; J Hassenpflug; D Varoga
Journal:  Z Orthop Unfall       Date:  2010-03       Impact factor: 0.923

9.  Biomechanics of two types of bone-tendon-bone graft for ACL reconstruction.

Authors:  S H Liu; J M Kabo; L Osti
Journal:  J Bone Joint Surg Br       Date:  1995-03

10.  A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction.

Authors:  Trevor B Birmingham; Dianne M Bryant; J Robert Giffin; Robert B Litchfield; John F Kramer; Allan Donner; Peter J Fowler
Journal:  Am J Sports Med       Date:  2008-01-11       Impact factor: 6.202

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  7 in total

1.  Current practice variations in the management of anterior cruciate ligament injuries in Delhi.

Authors:  Raju Vaishya; Amit Kumar Agarwal; Sachin Ingole; Vipul Vijay
Journal:  J Clin Orthop Trauma       Date:  2016-01-21

2.  Patient satisfaction with health is substantially improved following ACL reconstruction.

Authors:  Philipp Minzlaff; Thomas Heidt; Matthias J Feucht; Johannes E Plath; Stefan Hinterwimmer; Andreas B Imhoff; Tim Saier
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2017-06-26       Impact factor: 4.342

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

Authors:  Riccardo Di Miceli; Carlotta Bustos Marambio; Alessandro Zati; Roberta Monesi; Maria Grazia Benedetti
Journal:  Joints       Date:  2017-09-15

4.  Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study.

Authors:  Robert F LaPrade; Melanie B Venderley; Kimi D Dahl; Grant J Dornan; Travis Lee Turnbull
Journal:  Orthop J Sports Med       Date:  2017-07-06

Review 5.  A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

Authors:  Aoife Healy; Sybil Farmer; Anand Pandyan; Nachiappan Chockalingam
Journal:  PLoS One       Date:  2018-03-14       Impact factor: 3.240

Review 6.  Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Medial Patellofemoral Ligament Reconstruction.

Authors:  Adam C Lieber; Michael E Steinhaus; Joseph N Liu; Daniel Hurwit; Theresa Chiaia; Sabrina M Strickland
Journal:  Orthop J Sports Med       Date:  2019-07-02

7.  Comparable Instrumented Knee Joint Laxity and Patient-Reported Outcomes After ACL Repair With Dynamic Intraligamentary Stabilization or ACL Reconstruction: 5-Year Results of a Randomized Controlled Trial.

Authors:  Johannes Glasbrenner; Michael J Raschke; Christoph Kittl; Elmar Herbst; Christian Peez; Thorben Briese; Philipp A Michel; Mirco Herbort; Clemens Kösters; Benedikt Schliemann
Journal:  Am J Sports Med       Date:  2022-08-25       Impact factor: 7.010

  7 in total

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