Clinical Question: Does bracing aft...

Clinical Question: Does bracing after repair of acute anterior cruciate ligament (ACL) injuries improve functional outcomes?

Setting: Outpatient (any)

subject of attention Design: Randomized controlled trial (nonblinded)

Allocation: Uncertain

Synopsis: In this meditation patients who had complete tears of the ACL and were operated forward within eight weeks of injury were assigned randomly to receive postoperative bracing (n = 47) or no bracing (n = 48) Although the authors described their allocation proces they did not describe whether the proces was masked.

To minimize the surgeons' potential general intent on functional outcomes, they all agreed to use the same surgical technique. The rehabilitation regimen was identical for all patients. All patients' knee were immobilized for the first three weeks after surgery For those wearing braces, the braces were adjusted to allow partial motion from three to six weeks after surgery After six weeks, these patients were fitted with an off-the-shelf functional knee brace, which they agreed to wear daily for six month and during all rigorous activities for at least united year. For the patients who were not braced, the knee immobilizer was remov three weeks after surgery The authors did not report whether they used intention-to-treat analysis or if the issues were assessed by persons unaware of the treatment assignment.

The subject of attention began with 100 patients and five dropp disclosed The authors did not account for these patients in their analysis. Also, they did not define what their main issue was and did not define several key-note outcomes, such as what constituted a "significant reinjury." They evaluated the patients at least sum of two units years after surgery. Only united person did not return to the presurgery of the same height of function. Two braced and three nonbraced patients sustained significant reinjuries to their knee There was no difference in range of motion or nerve between the groups. Because this reflection did not include enough patients to determine with certainty that bracing causes no difference, a systematic review is needed

Bottom Line: In this thought the use of bracing following the surgical repair of acutely torn ACLs does not impede reinjury or speed the get back to original level of activity. (Level of Evidence: 2b-)

application of mind Reference: McDevitt ER, et al. Functional bracing after anterior cruciate ligament reconstruction: a prospective, randomized, multicenter subject of attention Am J Sports Med December 2004;32:1887-92

Used with permission from Barry H Bracing after ACL repair doesn't aid function. Accessed online January 25 2005 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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