This article is more than 5 years old. Information may no longer be current.
Bracing showed mixed effects on patient outcomes following revision ACL reconstruction
Click Here to Manage Email Alerts
COLORADO SPRINGS, Colo. — The use of an ACL brace in patient rehabilitation following revision ACL reconstruction provided mixed results, according to study data presented here at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“The use of a ACL derotation brace in the time of return to sport, which typically would be several months after the reconstruction, improved sport outcome scores on patient-reported outcomes,” Rick W. Wright, MD, told Orthopedics Today in an interview. “Although, it did not significantly impact graft retear.”
Wright and colleagues evaluated 694 patients with a median age of 27 years who underwent revision ACL reconstruction between 2006 and 2011. Patients were studied for a period of 2 years postoperatively. Metrics analyzed by the researchers included demographics, surgical technique/pathology, prescribed postoperative rehabilitation and its instructions, and patient-recorded outcome metrics (IKDC, KOOS and Marx activity rating scores). Risk factors for clinical outcomes at final follow-up were able to be determined using a multivariable analysis to control for age, gender, activity level, baseline outcome scores and rehabilitationrelated variables.
Patients who were prescribed an ACL brace for return to sport had significantly better KOOS sports/rec scores at final follow-up than patients who were not prescribed an ACL brace. However, patients who were prescribed an ACL derotation brace for use in early rehabilitation were 2.26-times more likely to have an additional surgery by final follow-up than patients who were not prescribed such a brace. Poorer patient-reported outcomes were linked to lower baseline outcome scores, activity level and female gender.
“The use of a rehab brace — like a knee immobilizer or a hinged knee brace — after surgery did not improve outcome. The use of a ACL derotation brace in the rehab period in the first few weeks negatively impacted outcome and had a higher reoperation rate,” Wright said.
Restricted passive or active range of motion, restricted full weight-bearing without support or a prescribed motion control brace postoperatively were not influential risk factors for 2-year outcomes, Wright said.
Wright and colleagues are continuing to follow up with patients at 6 years by asking and answering a variety of important questions.
“We are continuing to follow this cohort at 6 years and have applied and submitted a competitive renewal for our R01 [Research Project Grant] NIH grant to look at 10-year follow-up and 10-year outcome in this cohort,” he said. – by Nhu Te and Christian Ingram
- Reference:
- Wright RW, et al. Paper #112. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-10, 2016; Colorado Springs, Colo.
Disclosure: Wright reports he receives research support from the NIH (NIAMS and NICHD) and is a board member of the American Board of Orthopaedic Surgery, American Orthopaedic Association and the American Orthopaedic Society for Sports Medicine.