Bracing showed mixed effects following revision ACL reconstruction

The use of an ACL brace in patient rehabilitation, following ACL reconstructing, provided mixed results, according to a study presented at The American Orthopaedic Society for Sports Medicine, AOSSM Annual Meeting in Colorado Springs, Colorado July 7, 2016.

Saratoga Cassidy Driscoll, seen here competing vs. Shaker in a Suburban Council game, wears an ACL protectant knee brace. Athletes can return to compete after tearing the stabilizing ligament in their knee, but not before a year of strenuous and often tedious rehab. J.S.Carras photo

Saratoga Cassidy Driscoll, seen here competing vs. Shaker in a Suburban Council game, wears an ACL protectant knee brace. Athletes can return to compete after tearing the stabilizing ligament in their knee, but not before a year of strenuous and often tedious rehab. J.S. Carras photo

by Christian Ingram, Healio Orthopedics Today Today July 8, 2016

While some data in this study supported patients being prescribed an ACL brace for return to sport, “rehab braces or ACL de-rotational braces utilized in rehab did not improve outcome and predicted a higher chance for subsequent surgery following revision,” Rick W. Wright MD, said in his presentation.

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 regression analysis to control for age, gender, activity level, baseline outcome scores and rehabilitation‐related 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 de-rotation brace for use in 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.

“All other rehab factors did not predict outcome at a significant level,” Wright said.

Source Healio Orthopedics Today

Rehabilitation Predictors of Clinical Outcome following Revision ACL Reconstruction, Rick W. Wright MD. Paper 112 American Orthopaedic Society for Sports Medicine, AOSSM Annual Meeting July 7, 2016. Colorado Springs, Colorado.

Anterior cruciate ligament reconstruction and rehabilitation: predictors of functional outcome, Francesco Della Villa, Margherita Ricci, Francesco Perdisa, Giuseppe Filardo, Jacopo Gamberini, Daniele Caminati, Stefano Della Villa. Joints. 2015 Oct-Dec; 3(4): 179–185. Published online 2016 Jan 31. doi: 10.11138/jts/2015.3.4.179

Also see
ACL repair improves, but rehab remains a slow go in The Troy Record

Knee Hyperextension as a Predictor of Failure in Revision ACL Reconstruction: A Prospective Cohort Study, Daniel E. Cooper, MD, Warren R. Dunn MD  MPH, Rick W. Wright MD, Amanda Haas MA, Laura J. Huston MS. American Orthopaedic Society for Sports Medicine, AOSSM Annual Meeting July 7, 2016. Colorado Springs, Colorado. Poster P438

Patient Outcomes and Predictors of Success After Revision Anterior Cruciate Ligament Reconstruction, William R. Johnson MD, Amun Makani MD, Andrew J. Wall BS, Ali Hosseini PhD, Perry Hampilos BA, Guoan Li PhD, and Thomas J. Gill IV MD. Orthop J Sports Med. 2015 Oct; 3(10): 2325967115611660. Published online 2015 Oct 27. doi: 10.1177/2325967115611660

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