The effect of knee brace misalignment on the anterior cruciate ligament: An experimental study.

Abstract:

BACKGROUND:Protective knee braces are used for rehabilitation or prevention. Due to poor patient compliance or slippage, the brace might be misaligned with the knee axis. OBJECTIVES:Does a misaligned knee brace stress the anterior cruciate ligament? STUDY DESIGN:It is an experimental study. METHODS:A strain sensor was implanted on the anterior cruciate ligament in eight limbs. The limbs were mounted in a knee simulator, muscle forces were applied and a cyclic motion from 10° to 60° flexion was performed under three conditions: unbraced, braced and with a misaligned brace. OUTCOME MEASURES:The outcome measures were anterior cruciate ligament strain and three-dimensional kinematics of the knee joint. RESULTS:The correctly aligned brace significantly reduced the anterior cruciate ligament strain at 10° compared to the unbraced condition from 0% to -1.54% (standard deviation = 1.4). The misaligned brace neutralised the effect of bracing to -0.06% (standard deviation = 1.1) anterior cruciate ligament strain. At 60° flexion angle, bracing had no statistically significant effect on the anterior cruciate ligament strain compared to the unbraced knee: -2.58% (standard deviation = 0.8) versus -1.64% (standard deviation = 1.0). The anterior cruciate ligament in the misaligned braced knee at 60° flexion with a strain of -1.1% (standard deviation = 0.9) was significantly more stressed than in the correctly aligned condition. An effect of bracing on knee kinematics was not detected. CONCLUSION:A correctly aligned knee brace reduced anterior cruciate ligament strain. By contrast, a misaligned brace tended to increase the anterior cruciate ligament strain compared to the unbraced knee. CLINICAL RELEVANCE:The correct alignment of the brace was identified as a key factor decisively influencing the effectiveness of bracing.

journal_name

Prosthet Orthot Int

authors

Hacker SP,Schall F,Ignatius A,Dürselen L

doi

10.1177/0309364618824443

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

309-315

issue

3

eissn

0309-3646

issn

1746-1553

journal_volume

43

pub_type

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