Anterior cruciate ligament injury and knee braces – perspectives for prevention and treatment. A review

.................................................................................................................................................. 4 Introduction ............................................................................................................................................. 4 Background .............................................................................................................................................. 6 Knee joint ................................................................................................................................................ 7 Anterior Cruciate Ligament reconstruction............................................................................................... 8 Anterior Cruciate Ligament injuries .......................................................................................................... 9 Overview ................................................................................................................................................10 Discussion ...............................................................................................................................................12 Prevention ..........................................................................................................................................12 Treatment ...........................................................................................................................................13 Conclusion ..............................................................................................................................................14 Literature ................................................................................................................................................15 Aalborg University Department of Health Science and Technology Sports Technology 4 Anterior cruciate ligament injury and knee braces – perspectives for prevention and treatment. A review Abstract This paper reviews the research of bracing, rehabilitation braces, functional knee braces (FKB) and prophylactic knee braces (PKB) within the last 15 years in The American Journal of Sports Medicine. The primary focus will be on the role of anterior cruciate ligament (ACL) injuries and ACL reconstruction and braces, both before and after an injury occurs. The classifications of the braces made by the American Association of Orthopaedics Surgeons were the rehabilitation braces, designed to protect ROM postsurgery. The functional knee braces (FKB) are custom-made and designed to provide stability in an unstable knee joint. The prophylactic knee braces (PKB) which are “off-the-shelf” (OTS) braces are designed to reduce the severity and prevent knee injuries (Rishiraj, Taunton, Lloyd-Smith, Woollard, & Regan, 2009). ACL injuries are costly and have devastating consequences for the patients’ activity level and life quality. In the US approximately 200.000 ACL reconstructions are done annually at a total cost of $4 billion for the surgeries alone (Liu, et al., 2014). The use of PKB has increased in sports thereby trying to decrease the severity of the knee injuries and reduce the number of knee injuries (Greene, Hamson, Bay, & Bryce, 2000). In spite of the fact that the use of PKB in sports to prevent or reduce knee injury has been evaluated the conclusions differ and the topic remains controversial (Sanders, Cates, Baker, Barber-Westin, Gladin, & Levy, 2011). Conclusion: Rehabilitation braces does what it is made to do which is to prevent flexion during the early healing phases and can be beneficial in the early phases of recovery but have no long term effect on the outcome. Both in non weight-bearing and weight-bearing situations a FKB reduces the anterior-posterior laxity and shear loading which is positive for athletes with ACL and PCL problems to avoid further injuries. PKB have an overall positive effect by reducing the rate of knee injuries. Some PBK’s reduce forward speed and agility so which brace should be used depends on the specific sport.