The effect of knee brace misalignment on the anterior cruciate ligament: An experimental study.
Knee
anterior cruciate ligament
brace
misalignment
Journal
Prosthetics and orthotics international
ISSN: 1746-1553
Titre abrégé: Prosthet Orthot Int
Pays: France
ID NLM: 7707720
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
pubmed:
6
2
2019
medline:
20
12
2019
entrez:
6
2
2019
Statut:
ppublish
Résumé
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. Does a misaligned knee brace stress the anterior cruciate ligament? It is an experimental study. 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. The outcome measures were anterior cruciate ligament strain and three-dimensional kinematics of the knee joint. 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. 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. The correct alignment of the brace was identified as a key factor decisively influencing the effectiveness of bracing.
Sections du résumé
BACKGROUND
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
OBJECTIVE
Does a misaligned knee brace stress the anterior cruciate ligament?
STUDY DESIGN
METHODS
It is an experimental study.
METHODS
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
METHODS
The outcome measures were anterior cruciate ligament strain and three-dimensional kinematics of the knee joint.
RESULTS
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
CONCLUSIONS
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
CONCLUSIONS
The correct alignment of the brace was identified as a key factor decisively influencing the effectiveness of bracing.
Identifiants
pubmed: 30717630
doi: 10.1177/0309364618824443
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM