Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee.
OBJECTIVE
To describe three-dimensional tibial and femoral movements in vivo and examine the effect of a brace on knee kinematics during moderate to intense activity.


METHODS
Skeletal kinematics of anterior cruciate ligament deficient knees was measured with and without braces during moderate to intense activity.


BACKGROUND
Invasive markers implanted into the tibia and femur are the most accurate means to directly measure skeletal motion and may provide a more sensitive measure of the differences between brace conditions.


METHODS
Steinmann traction pins were implanted into the femur and tibia of four subjects having a partial or complete anterior cruciate ligament rupture. Non-braced and braced conditions were randomly assigned and subjects jumped for maximal horizontal distance to sufficiently stress the anterior cruciate ligament.


RESULTS
Intra-subject peak vertical force and posterior shear force were generally consistent between conditions. Intra-subject kinematics was repeatable but linear displacements between brace conditions were small. Differences in angular and linear skeletal motion were observed across subjects. Bracing the anterior cruciate ligament deficient knee resulted in only minor kinematic changes in tibiofemoral joint motion.


CONCLUSIONS
In this study, no consistent reductions in anterior tibial translations were observed as a function of the knee brace tested. Relevance. Investigations have reported that knee braces fail when high loads are encountered or when load is applied in an unpredictable manner. Questions remain regarding tibiofemoral joint motion, in particular linear displacements. The pin technique is a means for direct skeletal measurement and may provide a more sensitive measure of the differences between brace conditions.
Ramsey
D K
DK
School of Human Kinetics, University of Ottawa, Ottawa, Canada. dan.ramsey@kbh.ki.se
Lamontagne
M
M
Wretenberg
P F
PF
Valentin
A
A
Engström
B
B
Németh
G
G
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D001915:Braces; D004867:Equipment Design; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000534:rehabilitation*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D016896:Treatment Outcome