[Role of orthoses in ligament injuries of the knee].
OBJECTIVE
To review the literature for the benefits of the three different knee braces (prophylactic, rehabilitation, functional) that can be used to treat ligament injuries of the knee. What is their influence on stability? Do they have adverse effects? Is their use justified?


METHODS
We searched the Medline and Embase databases with use of the keywords knee, orthoses, brace, proprioception, stability, rehabilitation, physical therapy, and anterior cruciate ligament for reports published between 1980 and 2003 and selected 93 articles, expert reports or literature reviews.


RESULTS
Anterior tibial displacement can be controlled with mechanical strains (150 N), which are lower than physiological restraints? (400 N). The control of joint position is improved by increasing proprioception. Soft tissue stiffness influences the control of anterior tibial displacement. The beneficial effects observed are mainly subjective. Our analysis of the literature showed limitations and variations in study methodologies.


CONCLUSIONS
We did not find any justification for use of either prophylactic or rehabilitation braces. Functional braces can improve stability, as reported by the patient, and may be used in some situations.
Médecine physique et réadaptation, CRF La Roseraie, 76310 Sainte-Adresse, France. marcgenty@aol.com
M
M
Genty
C
C
Jardin
D001696:Biomechanical Phenomena; D001915:Braces; D004576:Electromyography; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation*; D007718:Knee Injuries / Q000534:rehabilitation*; D008023:Ligaments, Articular / Q000293:injuries*; D016059:Range of Motion, Articular; D013028:Space Perception; D016896:Treatment Outcome