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Functional Bracing After Anterior Cruciate Ligament Reconstruction

A Prospective, Randomized, Multicenter Study

Edward R. McDevitt, CPT (Retired), MC, USN^*, Dean C. Taylor, COL, MC, USA^,, Mark D. Miller, MD, LTC, MC, USAF Reserve, John P. Gerber, MAJ, SP, USA, Gregg Ziemke, CDR, MSC, USN^*, Daniel Hinkin, LTC (Retired), MC, USAF^ll, John M. Uhorchak, COL (Retired), MC, USA, Robert A. Arciero, COL (Retired), MC, USA and Patrick St. Pierre, COL (Retired), MC, USA

From the ^* Departments of Orthopaedics and Sports Medicine and Physical Therapy Departments of the United States Naval Academy, Annapolis, Maryland, the United States Military Academy, West Point, New York, the University of Virginia, Charlottesville, Virginia, and the ^ll United States Air Force Academy, Colorado Springs, Colorado

Address correspondence to Col. Dean C. Taylor, MC, Keller Army Community Hospital, Orthopaedic Service, 900 Washington Road, West Point, NY 10996-1197 (e-mail: dean.taylor{at}na.amedd.army.mil).

Background: Bracing after anterior cruciate ligament reconstruction is expensive and is not proven to prevent injuries or influence outcomes.

Purpose: To determine whether postoperative functional knee bracing influences outcomes.

Study Design: Prospective, randomized, multicenter clinical trial.

Methods: One hundred volunteers from the 3 US service academies with acute anterior cruciate ligament tears were randomized into braced or nonbraced groups. Only those subjects with anterior cruciate ligament tears treated surgically within the first 8 weeks of injury were included. Patients with chondral injuries, significant meniscal tears, or multiple knee ligament injuries were excluded. Surgical procedures and the postoperative physical therapy protocols were identical for both groups. The braced group was instructed to wear an off-the-shelf functional knee brace for all cutting, pivoting, or jumping activities for the first year after surgery.

Results: Ninety-five subjects were available with a minimum 2-year follow-up. There were no statistically significant differences between groups in knee stability, functional testing with the single-legged hop test, International Knee Documentation Committee scores, Lysholm scores, knee range of motion, or isokinetic strength testing. Two braced subjects had reinjuries, and 3 nonbraced subjects had reinjuries.

Conclusions: In this young, active population, postoperative bracing does not appear to change the clinical outcomes after anterior cruciate ligament reconstruction.

Key Words: functional bracing • anterior cruciate ligament (ACL) • knee braces • postoperative bracing • knee reconstruction

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