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Written by Gary Plancher
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Friday, 27 November 2009 14:43 |
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Methods of preventing and treating knee injuries have changed with the rapid development and refinement of knee braces. Prophylactic knee braces are designed to protect uninjured knees from valgus stresses that could damage the medial collateral ligaments.
Functional knee braces are intended to stabilize knees during rotational and anteroposterior forces. They offer a useful adjunct to the treatment and rehabilitation of ligamentous knee injuries. Patellofemoral knee braces have been used to treat anterior knee disorders and offer moderate subjective improvement without significant disadvantages.
Knee Brace Classification and Summary
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Brace type
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Indications
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Contraindications
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Reported benefits/evidence
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Risks/limitations
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| Prophylactic knee braces |
MCL protection against valgus knee stresses
Re-injury protection after previous MCL injury
Athletes at high risk for MCL injury |
To limit rotational control in ACL-deficient knees
Unstable knees requiring operative therapy |
Reduction of frequency and severity of MCL injuries following valgus knee stresses
Supporting cruciate ligaments during rotational stresses
Enhanced knee proprioception |
Injuries increased by excessivepreloading of MCL
Limited speed and athleticism
False sense of security for previously injured knee
Brace-related contact injuries to other players |
| Functional knee braces |
Reduce translation and rotation following ACL injury
Additional support after ACL surgery
Support for mild to moderate PCL or MCL instability |
Unstable knees requiring operative therapy
Complicated multi-directional knee injuries such as posterolateral corner injuries |
Laboratory evidence of reduced tibial rotation and knee AP translation
Subjective reports of decreased pain, enhanced performance, and improved confidence during athletics
Control of knee hyperextension
Augmented knee proprioception |
Reported effects on translation and rotation disappear at physiologic levels of use
Increased energy expenditure and decreased agility
False sense of confidence following ACL reconstruction
Brace-related contact injuries to other players |
| Patellofemoral knee braces |
Patellar subluxation and/or dislocation
Patellar tendonitis
Chondromalacia of the patella
Postsurgical effusion control |
Knee disorders unrelated to the patellofemoral joint
Knee translation or rotational control
Unstable knees requiring operative therapy |
Improved patellar tracking during knee flexion and extension
Dissipated lateral patellar forces
Decreased anterior knee pain syndromes
Subjective reports of decreased pain, enhanced performance and improved confidence during athletics |
Subjective benefits exceed objective findings
Increased skin irritation and lesions
Relatively insignificant pain relief with regular brace wear
Less effective than conservative therapy (simple stretching and strengthening) |
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| MCL = medial collateral ligament; ACL = anterior cruciate ligament; PCL = posterior cruciate ligament; AP = anteroposterior. |
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