Bracing versus non-bracing after anterior cruciate ligament reconstruction surgery

Rebin Taha  Salih; Zohair Mohsen  Al-Saffar

doi:10.56056/amj.2020.118

Authors

Rebin Taha Salih Candidate for KHCMS in Orthopedic Surgery M.B.CH. B, Erbil Teaching Hospital- Department of Orthopedic surgery- Erbil-Iraq
Zohair Mohsen Al-Saffar M.B.Ch.B., F.I.C.M.S.Ortho. Assistant Professor of Orthopedic Surgery, Department of Orthopedic Surgery, College of Medicine, Hawler Medical University (HMU), Erbil-Iraq.

DOI:

https://doi.org/10.56056/amj.2020.118

Keywords:

Anterior cruciate ligament, Brace, Knee, Pain

Abstract

Background and objectives:Anterior cruciate ligament reconstruction is a common procedure which can allow pa- tients to return to their active lifestyle. Knee braces have been prescribed frequently to protect the anterior cruciate lig- ament graft after reconstruction. The aim of this study was to see the effect of postoperative bracing with non-bracing after one year follow-up.

Methods:Thirty consecutive patients with a unilateral anterior cruciate ligament rupture were reconstructed. The first 15 patients were supplied postoperatively with a knee brace for 6 weeks. The next 15 patients were not supplied with a brace. The follow-up was based on the Lysholm functional score, Tegner activity level, manual Lachman test and pain by visual analog scale, each variable were recorded before surgery, 12 weeks, 24 weeks and one year after the surgery.

Results: After one year follow up, the results of this study showed no statistically significant differences between the brace and non-brace groups with regard to Lysholm score (mean with brace was 87.26, with- out brace was 87.80), Tegner activity level (mean with brace was 6.26, without brace was 6.40 ) and manual Lachman test; however, the pain score was less with brace group in the short term follow up (at 12th postoperative week) but no statistically significant differences was found between the groups after 1 year follow up.

Conclusions: Weather using functional brace or not after anterior cruciate ligament reconstruction depends on the orthopedic surgeon and the psychology and pain threshold of the patient.

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References

Canale ST, Azar FM, Beaty JH, Campbell WC. Campbell’s operative orthopaedics. Thirteenth edition. Philadelphia, PA: Elsevier, Inc; 2017.

Kinikli G, Callaghan M, Parkes M, Yuksel I. Bracing After Anterior Cruciate Ligament Reconstruction: Systematic Review and Meta-Analysis. Turkiye Klinikleri J Sports Sci. 2014 6;6:28–38.

Rishiraj N, Taunton JE, Lloyd-Smith R, Woollard R, Regan W, Clement DB. The potential role of prophylactic/functional knee bracing in preventing knee ligament injury. Sports Med. 2009;39(11):937–60.

Smith SD, Laprade RF, Jansson KS, Arøen A, Wijdicks CA. Functional bracing of ACL injuries: current state and future directions. Knee Surg Sports Traumatol Arthrosc. 2014;22(5):1131–41.

McDevitt ER, Taylor DC, Miller MD, et al. Functional bracing after anterior cruciate ligament reconstruction: a prospective, randomized, multicenter study. Am J Sports Med. 2004;32(8):1887–92.

Feller J, Bartlett J, Chapman S, at al. Use of an extension-assisting brace following anterior cruciate ligament reconstruction. Knee Surgery. 1997 1;5(1):6–9.

Delgado DA, Lambert BS, Boutris N, et al. Validation of Digital Visual Analog Scale Pain Scoring with a Traditional Paper-based Visual Analog Scale in Adults. JAAOS Global Research & Reviews. 2018;2(3):e088.

Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982;10(3):150–4.

Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;(198):43–9.

Gurtler RA, Stine R, Torg JS. Lachman test evaluated. Quantification of a clinical observation. Clin Orthop Relat Res. 1987;(216):141–50.

Eshuis R, Lentjes GW, Tegner Y, Wolterbeek N, Veen MR. Dutch Translation and Cross-cultural Adaptation of the Lysholm Score and Tegner Activity Scale for Patients with Anterior Cruciate Ligament Injuries. J Orthop Sports Phys Ther. 2016;46(11):976–83.

Rodríguez-Merchán EC. Knee Bracing After Anterior Cruciate Ligament Reconstruction. Orthopedics. 2016 ;39(4):602-9.

Di Miceli R, Marambio CB, Zati A, Monesi R, Benedetti MG. Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction? Joints. 2017 15;5(4):202–6.

Benjaminse A, Gokeler A, van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther. 2006;36(5):267–88.

Bordes P, Laboute E, Bertolotti A, et al. No beneficial effect of bracing after anterior cruciate ligament reconstruction in a cohort of 969 athletes followed in rehabilitation. Ann Phys Rehabil Med. 2017;60(4):230–6.

Brandsson S, Faxén E, Kartus J, Eriksson BI, Karlsson J. Is a knee brace advantageous after anterior cruciate ligament surgery? A prospective, randomised study with a two-year follow-up. Scand J Med Sci Sports. 2001;11(2):110–4.

Birmingham TB, Bryant DM, Giffin JR, et al. A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. Am J Sports Med. 2008;36(4):648–55.

Harilainen A, Sandelin J. Post-operative use of knee brace in bone-ten-don-bone patellar tendon anterior cruciate ligament reconstruction: 5year followup results of a randomized prospective study. Scand J Med Sci Sports. 2006;16(1):14–8.

Sterett WI, Briggs KK, Farley T, Steadman JR. Effect of functional bracing on knee injury in skiers with anterior cruciate ligament reconstruction: a prospec- tive cohort study. Am J Sports Med. 2006;34(10):1581–5.

Melegati G, Tornese D, Bandi M, Volpi P, Schonhuber H, Denti M. The role of the rehabilitation brace in restoring knee extension after anterior cruciate ligament reconstruction: a prospective controlled study. Knee Surg Sports Trau- matol Arthrosc. 2003;11(5):322–6.

Rebel M, Paessler HH. The effect of knee brace on coordination and neu- ronal leg muscle control: an early postoperative functional study in anterior cruciate ligament reconstructed patients. Knee Surg Sports Traumatol Arthrosc. 2001;9(5):272–81.

Masini BD, Owens BD. Current recommendations for anterior cruciate ligament bracing: when to use. Phys Sportsmed. 2013;41(1):35–9.

Dubljanin-Raspopovi E, Bumbasirevi M, Devecerski G, Matanovi D. The ef- fects of functional knee bracing after anterior cruciate ligament reconstruction. Med Pregl. 2009;62(9–10):483–7.

Smith TO, Davies L. A systematic review of bracing following reconstruction of the anterior cruciate ligament. Physiotherapy. 2008 1;94(1):1–10.