Influence of a mono-centric knee brace on the tension of the collateral ligaments in knee joints after sectioning of the anterior cruciate ligament––an in vitro study

Abstract

Objective. To analyze the influence of knee bracing on the tension of the medial and lateral collateral ligaments in anterior cruciate ligament deficiency. Design. The tension of the collateral ligaments in anterior cruciate ligament deficient knees was measured with and without knee bracing using an in vitro model. Background. Anterior cruciate ligament deficiency increases the tension in both collateral ligaments at the knee joint. Therefore knee braces should reduce that tension increase. However, that effect has never been proven quantitatively. Methods. After anterior cruciate ligament-transection, the forces of the medial (anterior/posterior part) and lateral collateral ligament were measured in ten fresh human cadaver knees at 0°, 20°, 40°, 60°, 80° and 100° of flexion, with and without application of a mono-centric knee brace. To quantify the ligament forces, strain gauges were fixed at the bony origins of the ligaments. Results. Bracing led to a significant decrease of ligament forces (20–100°: P<0.0001) in the anterior part of the medial collateral ligament in all joint positions. In the posterior aspect, this effect was observed only at 40° ( P<0.0001) and 80° ( P=0.001) of flexion. In the lateral collateral ligament, bracing caused a strain reduction from 60° to 100° of flexion ( P<0.0001). Therefore a flexion angle dependent effect of knee bracing on the strain was seen in the posterior aspect of the medial and in the lateral collateral ligament in anterior cruciate ligament deficient knee joints. Conclusions. Application of a mono-centric knee brace leads to a significant position dependent reduction of collateral ligament tension after anterior cruciate ligament-rupture. Relevance The over-all force reducing effect of applying a mono-centric knee brace may contribute to counteract the increasing knee laxity seen in some conservatively treated anterior cruciate ligament-patients over time.