Can a Knee Brace Prevent ACL Reinjury: A Systematic Review

Abstract

This systematic review aimed to investigate whether the use of a knee brace when returning to sport (RTS) could prevent a second injury after anterior cruciate ligament reconstruction (ACLR). This study was registered with the PROSPERO database and followed PRISMA guidelines. A systematic search of PubMed, Ovid Medline, Ovid All EBM Reviews, Ovid Embase, EBSCO Sportdiscus and ISI Web of Science databases for meta-analysis, randomized controlled trials and prospective cohort studies published before July 2020 was undertaken. The inclusion criteria were: (1) Comparing with and without a brace at RTS, (2) follow up of at least 18 months after ACLR, (3) reinjury rates included in the outcomes. Two reviewers independently extracted the data. Quality appraisal analyses were performed for each study using the Cochrane Collaboration tools for randomized and nonrandomized trials. A total of 1196 patients in three studies were included. One study showed a lower rate of reinjury when wearing a knee brace at RTS. One study found the knee brace to have a significant protective effect for younger patients (≤17 years). The effectiveness of knee bracing when RTS remains ambiguous. Current data cannot support that using a knee brace when RTS will decrease the rate of reinjury after ACL reconstruction.

A comparison of stiffness of six knee braces with application for posterolateral corner reconstructions

“… 9 A more recent systematic review similarly found that the effectiveness of bracing at time of return to sport remains ambiguous. 10 Bracing after posterior cruciate ligament reconstruction (PCLR) however, is a commonly agreed upon treatment recommendation. In a review of published PCLR rehabilitation protocols, 42 of 44 protocols advocated for immediate and prolonged bracing after surgery.…”

Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol

“…A hard frame brace is used in the majority of rehabilitation protocols following ACLR to reduce strain on the reconstructed ligament [31]. However, the influence of postoperative bracing remains unclear due to a lack of comparative studies [32]. In a recent randomized controlled trial (RCT) of 114 patients, brace-free rehabilitation after hamstring ACLR was found to result in equivalent postoperative PROM scores at the one-year followup compared with a rehabilitation protocol that included a brace for 6 weeks [16].…”