Abstract
This systematic review aimed to investigate whether the use of a knee brace when returning to sport (RTS) could prevent a second injury after anterior cruciate ligament reconstruction (ACLR). This study was registered with the PROSPERO database and followed PRISMA guidelines. A systematic search of PubMed, Ovid Medline, Ovid All EBM Reviews, Ovid Embase, EBSCO Sportdiscus and ISI Web of Science databases for meta-analysis, randomized controlled trials and prospective cohort studies published before July 2020 was undertaken. The inclusion criteria were: (1) Comparing with and without a brace at RTS, (2) follow up of at least 18 months after ACLR, (3) reinjury rates included in the outcomes. Two reviewers independently extracted the data. Quality appraisal analyses were performed for each study using the Cochrane Collaboration tools for randomized and nonrandomized trials. A total of 1196 patients in three studies were included. One study showed a lower rate of reinjury when wearing a knee brace at RTS. One study found the knee brace to have a significant protective effect for younger patients (≤17 years). The effectiveness of knee bracing when RTS remains ambiguous. Current data cannot support that using a knee brace when RTS will decrease the rate of reinjury after ACL reconstruction.
Highlights
More than 200,000 anterior cruciate ligament (ACL) injuries occur in the United States every year [1,2,3], with over 100,000 individuals undergoing ACL reconstruction (ACLR)annually
This study was registered with the PROSPERO database on 5 July 2020 under the following question, «Does the use of knee brace, after ACLR, when returning to sport reduce the rate of second injury?»
The purpose of this systematic review was to investigate the effect of knee braces when returning to sport after ACLR on reinjury rates
Summary
More than 200,000 anterior cruciate ligament (ACL) injuries occur in the United States every year [1,2,3], with over 100,000 individuals undergoing ACL reconstruction (ACLR)annually. Rehabilitation plays a crucial role in the success of the primary reconstruction; subsequent knee injury is common following ACLR. Recent literature shows a rate of ACL retear after ACLR when returning to sport between 8% and 23%, depending on the population and clinical implications [4,5]. A second ACL injury, either a graft rupture or contralateral ACL injury after ACLR, negatively impacts knee function [8,9,10], quality of life [11,12], accelerates degenerative changes in the knee [11,13,14,15] and challenges an athlete’s career [16,17,18,19]. A recent survey managed by the American Orthopaedic Society for Sports Medicine demonstrated that 63% of surgeons who perform ACLR recommend the
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