title: Bracing can partially limit tibial rotation during stressful activities after anterior crucial ligament reconstruction with a hamstring graft.
abstract: Hamstring graft has substantial differences with BPTB graft regarding initial mechanical strength, healing sequence, and vascularization, which may imply that a different approach during rehabilitation period is required. The purpose of this study was to investigate the influence of knee bracing on tibial rotation in ACL-reconstructed patients with a hamstring autograft during high loading activities. The hypothesis was that there would be a decrease in tibial rotation in the ACL-reconstructed braced knee as compared to the unbraced knee.
  
  
  
  Twenty male patients having undergone unilateral ACL reconstruction with a semitendinosus/gracilis autograft were assessed. Kinematic data were collected with an eight-camera optoelectronic system during two stressful tasks: (1) descending from a stair and subsequent pivoting; and (2) landing from a platform and subsequent pivoting. In each patient, three different experimental conditions were evaluated: (A) wearing a prophylactic brace (braced condition); (B) wearing a patellofemoral brace (sleeved condition); (C) without brace (unbraced condition). The intact knee without brace served as a control.
  
  
  
  Tibial rotation was significantly lower in the intact knee compared to all three conditions of the ACL-reconstructed knee (P≤0.01 for both tasks). Presence of a brace or sleeve resulted in lower tibial rotation than in the unbraced condition (p=0.003 for descending/pivot and P=0.0004 for landing/pivot). The braced condition resulted in lower rotation than the sleeved condition for descending/pivoting (P=0.031) while no differences were found for landing/pivoting (P=0.230).
  
  
  
  Knee bracing limited the excessive tibial rotation during pivoting under high loading activities in ACL-reconstructed knees with a hamstring graft. This partial restoration of normal kinematics may have a potential beneficial effect in patients recovering from ACL reconstruction with a hamstring autograft.
  
  
  
  Level III, case-control therapeutic study.
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Giotis
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece; Department of biomedical engineering, university of California, One Shields Avenue, Davis, 95616, CA, USA. Electronic address: npaschos@ucdavis.edu.
authors.forename: N K
authors.initials: NK
authors.lastname: Paschos
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Zampeli
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece; Discipline of physiotherapy, faculty of health sciences, university of Sydney, Sydney, NSW, Australia; Department of physical therapy, Long Island university, Brooklyn campus, Brooklyn, New York, USA.
authors.forename: E
authors.initials: E
authors.lastname: Pappas
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Mitsionis
authors.affiliation: Orthopaedic sports medicine center, department of orthopaedic surgery, university of Ioannina, Ioannina, Greece.
authors.forename: A D
authors.initials: AD
authors.lastname: Georgoulis
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D001696:Biomechanical Phenomena / Q000502:physiology; D001915:Braces; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D007719:Knee Joint; D008297:Male; D012399:Rotation; D013977:Tibia / Q000502:physiology*; D055815:Young Adult
keywords: Anterior cruciate ligament rehabilitation; Knee kinematics patellofemoral brace; Prophylactic brace; Semitendinosus/gracilis