title: No beneficial effect of bracing after anterior cruciate ligament reconstruction in a cohort of 969 athletes followed in rehabilitation.
abstract: OBJECTIVE
  Compare the clinical outcomes of different knee braces in the early phase of rehabilitation after anterior cruciate ligament reconstruction (ACLR) in athletes.
  
  
  METHODS
  We conducted a retrospective database study of athletes during early rehabilitation in a tertiary referral hospital between 1 February 2008 and 30 October 2010 after ACLR using bone patellar tendon bone (BPTB) or hamstring autograft. Differences in mid-patellar knee circumference, pain, and range of motion were assessed at admission. All patients followed the same rehabilitation protocol. Patients who had complications preventing them from following the assigned rehabilitation program were analyzed separately. Patients who completed their rehabilitation program were also assessed for thigh muscle atrophy, extension deficit≥2°, quality of walking, PPLP1 and subjective IKDC scores. The type and frequency of complications and their frequency was documented. The above-mentioned parameters were analyzed in 3 different groups: rigid brace in full extension, articulated brace (0°-90° for first 3 weeks then 0-120°) or no brace.
  
  
  RESULTS
  The analysis included 969 patients. Rehabilitation started at 4.5±2.9 days after surgery and ended at 32.4±3.0 days postoperative. At the beginning, flexion was lower in patients with a rigid brace (P<0.01). There was no difference in the frequency or severity of complications between the three study groups, nor was there a significant difference in the clinical outcomes listed above.
  
  
  CONCLUSIONS
  Postoperative bracing after ACLR has not beneficial effect on clinical outcomes and the complication rate. Patients who wore the rigid brace had limited flexion early on.
authors.affiliation: Service de Médecine Physique et Réadaptation, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: pborde101e@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Bordes
authors.affiliation: CERS, 83, avenue Maréchal-de-Lattre-de-Tassigny, 40130 Capbreton, France.
authors.forename: E
authors.initials: E
authors.lastname: Laboute
authors.affiliation: U897 Inserm, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Bertolotti
authors.affiliation: UMR 1094, Inserm, faculté de médecine de Limoges, 2, rue du Docteur-Marcland, 87025 Limoges cedex, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Dalmay
authors.affiliation: CERS, 83, avenue Maréchal-de-Lattre-de-Tassigny, 40130 Capbreton, France.
authors.forename: P
authors.initials: P
authors.lastname: Puig
authors.affiliation: CERS, 83, avenue Maréchal-de-Lattre-de-Tassigny, 40130 Capbreton, France.
authors.forename: P
authors.initials: P
authors.lastname: Trouve
authors.affiliation: CERS, 83, avenue Maréchal-de-Lattre-de-Tassigny, 40130 Capbreton, France.
authors.forename: E
authors.initials: E
authors.lastname: Verhaegue
authors.affiliation: Service de Médecine Physique et Réadaptation, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: P A
authors.initials: PA
authors.lastname: Joseph
authors.affiliation: Service de Médecine Physique et Réadaptation, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Dehail
authors.affiliation: Service de Médecine Physique et Réadaptation, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: De Seze
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D056352:Athletes; D001915:Braces; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Anterior cruciate ligament reconstruction; Knee brace; Postoperative complications; Rehabilitation