title: Rehabilitation results following anterior cruciate ligament reconstruction using a hard brace compared to a fluid-filled soft brace.
abstract: The purpose of this study was to compare the clinical outcomes of rehabilitation after ACL reconstruction using a water-filled soft brace to those using a hard brace. The method used in this study was a prospective randomised clinical trial including 36 patients wearing a hard brace and 37 patients wearing a water-filled soft brace for 6 weeks after surgery. Preoperative and postoperative (seven examinations) clinical evaluation within a follow-up period of 1 year including effusion status, swelling and range of motion (ROM), IKDC 2000, KT1000 Arthrometer, Lysholm knee scoring scale and Tegner activity score. Mean values are presented with standard deviations. Data was analysed using descriptive statistics and Student's t-test for unpaired samples. Significantly less effusion was found in the soft brace group from 5 days (p=0.002) to 12 weeks (p<0.024) postoperative. Hard brace patients presented with significantly more extension deficit from 5 days (p=0.036) to 12 months (p=0.014) postoperative but no significant difference was detected in complete ROM, laxity or thigh atrophy at any follow-up examination. Patients treated with a soft brace had significantly higher IKDC subjective ratings at 6 weeks (p=0.02) up to 12 months after operation (p=0.002) and rated significantly higher in Tegner activity score (p=0.004) and Lysholm knee scoring scale (p=0.006) 6 and 12 months (p<0.001 for both scores) postoperatively. The water-filled soft brace was superior regarding effusion, swelling, extension deficit and patient-measured midterm outcome. The soft brace presents a safe, easy-to-use and effective alternative to the hard brace.
authors.affiliation: Clinic for Orthopaedic Surgery, Martin Luther University Halle, Magdeburger Strasse 22, 06097 Halle (Saale), Germany. hermann.mayr@medizin.uni-halle.de
authors.forename: Hermann Otto
authors.initials: HO
authors.lastname: Mayr
authors.forename: Alfred
authors.initials: A
authors.lastname: Hochrein
authors.forename: Werner
authors.initials: W
authors.lastname: Hein
authors.forename: Robert
authors.initials: R
authors.lastname: Hube
authors.forename: Anke
authors.initials: A
authors.lastname: Bernstein
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001915:Braces; D004487:Edema / Q000209:etiology / Q000473:pathology; D006305:Health Status Indicators; D006801:Humans; D006833:Hydrarthrosis / Q000209:etiology / Q000473:pathology; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000534:rehabilitation*; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult