Bracing showed mixed effects on patient outcomes following revision ACL reconstruction
COLORADO SPRINGS, Colo. — According to a speaker here, the use of an ACL brace in patient rehabilitation following ACL reconstructing provided mixed results.
While some data in this study supported patients being prescribed an ACL brace for return to sport, “rehab braces or ACL de-rotational braces utilized in rehab did not improve outcome and predicted a higher chance for subsequent surgery following revision,” Rick W. Wright, MD, said in his presentation.
Wright and colleagues evaluated 694 patients with a median age of 27 years who underwent revision ACL reconstruction between 2006 and 2011. Patients were studied for a period of 2 years postoperatively. Metrics analyzed by the researchers included demographics, surgical technique/pathology, prescribed postoperative rehabilitation and its instructions, and patient-recorded outcome metrics (IKDC, KOOS and Marx activity rating scores). Risk factors for clinical outcomes at final follow-up were able to be determined using a regression analysis to control for age, gender, activity level, baseline outcome scores and rehabilitation‐related variables.
Patients who were prescribed an ACL brace for return to sport had significantly better KOOS sports/rec scores at final follow-up than patients who were not prescribed an ACL brace. However, patients who were prescribed an ACL de-rotation brace for use in rehabilitation were 2.26-times more likely to have an additional surgery by final follow-up than patients who were not prescribed such a brace. Poorer patient-reported outcomes were linked to lower baseline outcome scores, activity level and female gender.
“All other rehab factors did not predict outcome at a significant level,” Wright said. – by Christian Ingram
Wright RW, et al. Paper #112. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-10, 2016; Colorado Springs, Colo.
Disclosure: Wright reports he receives research support from the NIH (NIAMS and NICHD) and is a board member of the American Board of Orthopaedic Surgery, American Orthopaedic Association and the American Orthopaedic Society for Sports Medicine.