A systematic review of bracing following reconstruction of the anterior cruciate ligament

ObjectivesTo determine whether the use of a postoperative knee brace following reconstruction of the anterior cruciate ligament (ACL) affects clinical outcomes.Data sourcesThe electronic databases AMED, Cinahl, Cochrane database, Embase, Medline (via Ovid), Physiotherapy Evidence Database (PEDro) and Pubmed were searched from their inception to August 2006. A manual search of pertinent specialist journals and the reference lists of identified articles was also performed.Review methodsAll English-language, human subject, controlled clinical trials that compared the effects of wearing a knee brace with not wearing a brace for 1 day to 3 months following ACL reconstruction were included. Two reviewers extracted the data independently from the included studies, and assessed the methodological quality of the literature using the PEDro scoring system.ResultsSeven papers comprising of 390 ACL reconstructions were included. There were no significant longer-term differences in outcomes between patients who wore knee braces and those who did not. The methodological assessment of the literature revealed a number of limitations, including not blinding assessors, not performing a power calculation to determine the sample size, and not concealing subject allocation.ConclusionsThere appeared to be no significant longer-term differences in clinical outcomes between patients who wore postoperative knee braces and those who did not. Areas for further study are suggested, most notably to assess this topic using more rigorous randomised controlled trial methodologies.