Download PDF
J Knee Surg 2022; 35(03): 242-248
DOI: 10.1055/s-0041-1740930
Special Focus Section

Efficacy of Prophylactic Knee Bracing in Sports

Kyle Blecha
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
,
Clayton W. Nuelle
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
,
Patrick A. Smith 
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
2   Columbia Orthopedic Group, Columbia, Missouri
,
James P. Stannard 
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
3   Department of Orthopedic Surgery, Thompson Laboratory of Orthopedic Institute, University of Missouri, Columbia, Missouri
,
Richard Ma 
1   Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries are common knee injuries, which can result from contact and noncontact during sports, recreation, or work-related activities. Prophylactic knee braces (PKBs) have been designed to protect the knee and decrease risk of recurrence of these injuries. Despite their success, PKBs have not been proven to be consistently effective and cost of the device must be evaluated to optimize its use in sports, particularly American football. Biomechanical studies have suggested that increased hip and knee flexion angles may reduce frontal plane loading with bracing which can protect the knee joint. This is essential with knee loading and rotational moments because they are associated with jumping, landing, and pivoting movements. The clinical efficacy of wearing PKBs can have an impact on athletic performance with respect to speed, power, motion, and agility, and these limitations are evident in athletes who are unaccustomed to wearing a PKB. Despite these concerns, use of PKBs increases in patients who have sustained an MCL injury or recovering from an ACL reconstruction surgery. As the evidence continues to evolve in sports medicine, there is limited definitive data to determine their beneficial or detrimental effects on overall injury risk of athletes, therefore leading those recommendations and decisions for their usage in the hands of the athletic trainers and team physicians' experience to determine the specific brace design, brand, fit, and situations for use.

Keywords

cost - sports medicine - prophylactic knee brace


Publication History

Received: 09 August 2021

Accepted: 16 November 2021

Article published online:
24 December 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Salata MJ, Gibbs AE, Sekiya JK. The effectiveness of prophylactic knee bracing in American football: a systematic review. Sports Health 2010; 2 (05) 375-379
    CrossrefPubMedSearch in Google Scholar
  • 2 Ewing KA, Begg RK, Galea MP, Lee PVS. Effects of prophylactic knee bracing on lower limb kinematics, kinetics, and energetics during double-leg drop landing at 2 heights. Am J Sports Med 2016; 44 (07) 1753-1761
    CrossrefPubMedSearch in Google Scholar
  • 3 Miyamoto RG, Bosco JA, Sherman OH. Treatment of medial collateral ligament injuries. J Am Acad Orthop Surg 2009; 17 (03) 152-161
    CrossrefPubMedSearch in Google Scholar
  • 4 Sinclair JK, Vincent H, Richards JD. Effects of prophylactic knee bracing on knee joint kinetics and kinematics during netball specific movements. Phys Ther Sport 2017; 23: 93-98
    CrossrefPubMedSearch in Google Scholar
  • 5 Baltaci G, Aktas G, Camci E, Oksuz S, Yildiz S, Kalaycioglu T. The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power. Knee Surg Sports Traumatol Arthrosc 2011;19(10):1722–1728
  • 6 Albright JP, Saterbak A, Stokes J. Use of knee braces in sport. Current recommendations. Sports Med 1995; 20 (05) 281-301
    CrossrefPubMedSearch in Google Scholar
  • 7 Hacker SP, Schall F, Niemeyer F, Wolf N, Ignatius A, Dürselen L. Do prophylactic knee braces protect the knee against impacts or tibial moments? An in vitro multisensory study. Orthop J Sports Med 2018; 6 (11) 2325967118805399
    Search in Google Scholar
  • 8 Wojtys EM, Kothari SU, Huston LJ. Anterior cruciate ligament functional brace use in sports. Am J Sports Med 1996; 24 (04) 539-546
    CrossrefPubMedSearch in Google Scholar
  • 9 Requa RK, Garrick JG. Clinical significance and evaluation of prophylactic knee brace studies in football. Clin Sports Med 1990; 9 (04) 853-869
    CrossrefPubMedSearch in Google Scholar
  • 10 Najibi S, Albright JP. The use of knee braces, part 1: prophylactic knee braces in contact sports. Am J Sports Med 2005; 33 (04) 602-611
    CrossrefPubMedSearch in Google Scholar
  • 11 Albright JP, Powell JW, Smith W. et al. Medial collateral ligament knee sprains in college football. Effectiveness of preventive braces. Am J Sports Med 1994; 22 (01) 12-18
    CrossrefPubMedSearch in Google Scholar
  • 12 Paluska SA, McKeag DB. Knee braces: current evidence and clinical recommendations for their use. Am Fam Physician 2000; 61 (02) 411-418 , 423–424
    PubMedSearch in Google Scholar
  • 13 France EP, Cawley PW, Paulos LE. Choosing functional knee braces. Clin Sports Med 1990; 9 (04) 743-750
    CrossrefPubMedSearch in Google Scholar
  • 14 Rovere GD, Haupt HA, Yates CS. Prophylactic knee bracing in college football. Am J Sports Med 1987; 15 (02) 111-116
    CrossrefPubMedSearch in Google Scholar
  • 15 Deppen RJ, Landfried MJ. Efficacy of prophylactic knee bracing in high school football players. J Orthop Sports Phys Ther 1994; 20 (05) 243-246
    CrossrefPubMedSearch in Google Scholar
  • 16 Greene DL, Hamson KR, Bay RC, Bryce CD. Effects of protective knee bracing on speed and agility. Am J Sports Med 2000; 28 (04) 453-459
    CrossrefPubMedSearch in Google Scholar
  • 17 Giotis D, Zampeli F, Pappas E, Mitsionis G, Papadopoulos P, Georgoulis AD. The effect of knee braces on tibial rotation in anterior cruciate ligament-deficient knees during high-demand athletic activities. Clin J Sport Med 2013; 23 (04) 287-292
    CrossrefPubMedSearch in Google Scholar
  • 18 Rebel M, Paessler HH. The effect of knee brace on coordination and neuronal leg muscle control: an early postoperative functional study in anterior cruciate ligament reconstructed patients. Knee Surg Sports Traumatol Arthrosc 2001; 9 (05) 272-281
    CrossrefPubMedSearch in Google Scholar
  • 19 Chew KTL, Lew HL, Date E, Fredericson M. Current evidence and clinical applications of therapeutic knee braces. Am J Phys Med Rehabil 2007; 86 (08) 678-686
    CrossrefPubMedSearch in Google Scholar
  • 20 Albright JP, Powell JW, Smith W. et al. Medial collateral ligament knee sprains in college football. Brace wear preferences and injury risk. Am J Sports Med 1994; 22 (01) 2-11
    CrossrefPubMedSearch in Google Scholar
  • 21 Teitz CC, Hermanson BK, Kronmal RA, Diehr PH. Evaluation of the use of braces to prevent injury to the knee in collegiate football players. J Bone Joint Surg Am 1987; 69 (01) 2-9
    CrossrefPubMedSearch in Google Scholar
  • 22 Sitler M, Ryan J, Hopkinson W. et al. The efficacy of a prophylactic knee brace to reduce knee injuries in football. A prospective, randomized study at West Point. Am J Sports Med 1990; 18 (03) 310-315
    CrossrefPubMedSearch in Google Scholar
  • 23 Kocher MS, Sterett WI, Briggs KK, Zurakowski D, Steadman JR. Effect of functional bracing on subsequent knee injury in ACL-deficient professional skiers. J Knee Surg 2003; 16 (02) 87-92
    PubMedSearch in Google Scholar
  • 24 Beynnon BD, Good L, Risberg MA. The effect of bracing on proprioception of knees with anterior cruciate ligament injury. J Orthop Sports Phys Ther 2002; 32 (01) 11-15
    CrossrefPubMedSearch in Google Scholar
  • 25 Wu GK, Ng GY, Mak AF. Effects of knee bracing on the functional performance of patients with anterior cruciate ligament reconstruction. Arch Phys Med Rehabil 2001; 82 (02) 282-285
    CrossrefPubMedSearch in Google Scholar
  • 26 Sanders MS, Cates RA, Baker MD, Barber-Westin SD, Gladin WM, Levy MS. Knee injuries and the use of prophylactic knee bracing in off-road motorcycling: results of a large-scale epidemiological study. Am J Sports Med 2011; 39 (07) 1395-1400
    CrossrefPubMedSearch in Google Scholar