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The Journal of Bone and Joint Surgery, Vol 74, Issue 9 1298-1312, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
The effect of functional knee-braces on strain on the anterior cruciate ligament in vivo
BD Beynnon, MH Pope, CM Wertheimer, RJ Johnson, BC Fleming, CE Nichols and JG Howe
McClare Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington 05405.
Functional knee-braces are widely used to protect injured or reconstructed
anterior cruciate ligaments, despite the fact that few scientific data
support their efficacy. We studied seven functional braces, representative
of both the typical custom-fit and off-the-shelf designs. The braces were
tested on subjects who had a normal anterior cruciate ligament and were
scheduled for arthroscopic meniscectomy or exploration of the knee under
local anesthesia. After the operative procedure, a Hall-effect
strain-transducer was applied to the anterior cruciate ligament. Under low
anterior shear loads, two braces provided some protective strain-shielding
effect compared with no brace, but this strain-shielding effect did not
occur at the higher anterior shear loads expected during the high-stress
activities common to athletic events. The DonJoy, Townsend, C.Ti., and
Lenox Hill braces demonstrated a strain-shielding effect on the anterior
cruciate ligament with an internal torque of five newton-meters applied to
the tibia. None of the braces had any effect on strain on the anterior
cruciate ligament during active range of motion of the knee from 10 to 120
degrees or during isometric contraction of the quadriceps. Wearing of a
brace did not produce an increase in the value for strain on the anterior
cruciate ligament. For the activities that were evaluated in this study,
none of the braces produced adverse effects on the anterior cruciate
ligament, and there were no significant differences in the strain on the
anterior cruciate ligament between the use of a custom-fit or an
off-the-shelf brace design. There were no apparent advantages of the more
expensive custom-made braces compared with the off-the-shelf designs.
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