J Korean Orthop Assoc.  2008 Dec;43(6):738-745.

Comparative Study of ACL Double-bundle Reconstruction with and without Functional Knee Brace: Minimum 1-year Follow-up Results

• Jung YB
• Jung HJ
• Nam CH
• Lee YS
• Yang JJ

Abstract

PURPOSE: To compare the clinical efficacy after an arthroscopic ACL double-bundle reconstruction with and without functional knee brace.
MATERIALS AND METHODS
Between July 2004 and May 2006, fifty patients who underwent an ACL double-bundle reconstruction with and without a functional knee brace for more than a 1-year follow-up were evaluated. The patients were treated with brace (Group 1, 22 cases) or without (Group 2, 28 cases) a brace after surgrey. Stability was assessed by maximal manual testing with a KT-1000 arthrometer, anterior stress radiographs using the Telos device and a lateral pivot shift test. The clinical results were assessed by the OAK (Orthopadische Arbeitsgruppe Knie) score, IKDC (International Knee Documentation Committee) score, mid thigh circumference and the range of motion.
RESULTS
More than one year after surgery, average of OAK score, IKDC score, lateral pivot shift test of the stability results and maximal manual testing with the KT-1000 arthrometer, stress radiographs with the Telos device, mid thigh circumference difference, range of motion of the clinical results were similar in both groups.
CONCLUSION
An ACL double-bundle reconstruction produces similar stability and clinical results regardlness of whether or not a functional knee brace is used.

Keyword

ACL double-bundle reconstruction; Functional knee brace

MeSH Terms

Braces
Follow-Up Studies
Humans
Knee
Range of Motion, Articular
Thigh

Figure

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  Fig. 1 Photograph of the functional brace.

Reference

1. Abbott LC, Saunders J, Bost FC, Anderson CE. Injury to the ligaments of the knee joint. J Bone Joint Surg Am. 1994. 26:503.

2. Aglietti P, Buzzi R, Zacchotti G, De Biase P. Patellar tendon versus double semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction. Am J Sport Med. 1994. 22:211–218.

3. Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am. 2004. 86:2143–2155.

4. Becker R, Schröder M, Röpke M, Starke C, Nebelung W. Structual properties of sutures used in anchoring multistranded hamstrings in anterior cruciate ligament reconstruction: a biomechanical study. Arthrosopy. 1999. 15:297–300.

5. Cadilhac J, Georgesco M, Carne P. Simon L, editor. L'amyotrophie d'immobilization due Quadriceps. Genou et Medecine de Reduction. 1978. Paris: Masson;33–37.

6. Campbell WC. Operative orthopaedics. 1980. 6th ed. St. Louis: C.V. Mosby Co;933.

7. Cawley PW, France EP, Paulos LE. The current state of functional knee bracing research. A review of the literature. Am J Sports Med. 1991. 19:226–233.

8. Cook FF, Tibone JE, Redfern FC. A dynamic analysis of a functional brace for anterior cruciate ligament insufficiency. Am J Sports Med. 1989. 17:519–524.

9. Ellison AE, Berg EE. Embryology, anatomy and function of the anterior cruciate ligament. Orthop Clin North Am. 1985. 16:3–14.

10. Enneking WF, Horowitz M. The intraarticular effects of immobilization on the human knee. J Bone Joint Surg Am. 1972. 54:973–985.

11. Fetto JF, Marshall JL. Injury to the anterior cruciate ligament producing the pivot-shift sign. J Bone Joint Surg Am. 1979. 60:710–714.

12. Fu FH, Bennett CH, Ma CB, Menetrey J, Lattermann C. Current trends in anterior cruciate ligament reconstruction. Part II. Operative procedures and clinical correlations. Am J Sports Med. 2000. 28:124–130.

13. Holden DL, Jackson DW. Treatment seclection in acute anterior cruciate ligament tears. Orthop Clin North Am. 1985. 16:99–109.

14. Howell SM, Taylor MA. Failure of reconstruction of the anterior cruciate ligament due to impingement by the intercondylar roof. J Bone Joint Surg Am. 1993. 75:1044–1055.

15. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part I: The medial compartment and cruciate ligaments. J Bone Joint Surg Am. 1976. 58:159–172.

16. Hughston JC, Eilers AF. The role of the posterior oblique ligament in repair of acute (collateral) ligament tears of the knee. J Bone Joint Surg Am. 1973. 55:923–940.

17. Jakob RP, Stäubli HU, Deland JT. Grading the pivot shift. Objective tests with implications for treatment. J Bone Joint Surg Br. 1987. 69:294–299.

18. Kennedy JC, Weinberg HW, Wilson AS. The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. J Bone Joint Surg Am. 1974. 56:223–235.

19. Liu SH, Lunsford T, Gude S, Vangsness CT Jr. Comparison of functional knee braces for control of anterior tibial displacement. Clin Orthop Relat Res. 1994. 303:203–210.

20. Liu SH, Mirzayan R. Current review. Functional knee bracing. Clin Orthop Relat Res. 1995. 317:273–281.

21. Maltry JA, Noble PC, Woods GW, Alexander JW, Feldman GW, Tullos HS. External stabilization of anterior cruciate ligament deficient knee during rehabilitation. Am J Sports Med. 1989. 17:550–554.

22. 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. 32:1887–1892.

23. Muller W. The knee. 1983. Berlin, Heidelberg, New York: Springer;266–282.

24. Norwood LA, Cross MJ. Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med. 1979. 7:23–26.

25. Noyes FR, Butler DL, Grood ES, Zernicke RF, Hefzy MS. Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions. J Bone Joint Surg Am. 1984. 66:344–352.

26. Noyes FR, Butler DL, Paulos LE, Grodd ES. Intraarticular cruciate reconstruction. I: perspectives on graft strength, vascularization and immediate motion after replacement. Clin Orthop Relat Res. 1983. 172:71–77.

27. Noyes FR, Mangine RE, Barber S. Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction. Am J Sports Med. 1987. 15:149–160.

28. O'Donoghue DH. Treatment of acute ligamentous injuries to the knee. Orthop Clin North Am. 1973. 4:617–645.

29. Shelbourne KD, Grat T. Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med. 2000. 28:446–452.

30. Shelbourne KD, Patel DV. Rehabilitation after autogenous bone-patellar tendon-bone ACL reconstruction. Instr Course Lect. 1996. 45:263–273.

31. Solcum DD, Larson RL. Late reconstruction of ligamentous injuries of the medial compartment of the knee. Clin Orthop Relat Res. 1974. 100:23–55.

32. Wiles P, Andrews PS, Devas MB. Chondromalacia of the patella. J Bone Joint Surg Br. 1956. 38:95–113.

33. Wojtys EM, Loubert PV, Samson SY, Viviano DM. Use of a knee-brace for control of tibial translation and rotation. A comparison, in cadavera, of available models. J Bone Joint Surg Am. 1990. 72:1323–1329.