The knee, the largest joint in the human body, is crucial for daily activities like walking, running, and climbing stairs. It comprises four major components: bones, cartilage, ligaments, and tendons, all working harmoniously to allow smooth movement. Unfortunately, the knee is also highly prone to injury, especially in cases of ligament damage or degenerative diseases like arthritis. Injuries to critical ligaments such as the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are prevalent in athletes, often causing debilitating pain and limiting mobility. In the USA alone, over 100,000 cases of ACL injuries are reported each year, with the majority resulting from sports activities (Mall et al., 2014). The high frequency of these injuries highlights the need for practical rehabilitation tools like knee braces.
Beyond sports-related injuries, knee braces significantly manage degenerative conditions like osteoarthritis (OA). Knee OA is a prevalent form of arthritis that affects a large portion of the aging population, significantly impairing mobility and making daily tasks burdensome. A study found that 16% of individuals aged 45 and older in the USA suffer from symptomatic knee OA (Jordan et al., 2009). For these individuals, non-invasive treatment options, including knee braces, are gaining popularity to alleviate pain and improve movement. Research has demonstrated that knee braces help stabilize the joint, reducing pain and enhancing gait (Jordan et al., 2009).
Functional knee braces are crucial in the rehabilitation process following ligament injuries, especially those involving the ACL. These braces have been shown to reduce knee joint instability by controlling tibial rotation and anteroposterior (AP) translation (Karam et al., 2011). They provide additional support after ACL surgery and are also used to manage mild to moderate instability of the posterior cruciate ligament (PCL) or MCL. Studies indicate that individuals wearing these braces report decreased pain, enhanced athletic performance, and improved confidence, likely due to increased proprioception and control over knee hyperextension (Beynnon et al., 1992).
The clinical importance of functional knee braces extends beyond athletic applications. These braces are now commonly recommended as part of conservative therapy for knee ligament injuries, especially in cases of anterior knee pain and ACL reconstruction. They offer significant benefits in controlling external knee rotation and anteroposterior translation, thereby protecting ACL grafts following surgery (Wojtys et al., 1996). The rehabilitative benefits of these braces make them an essential component in the treatment and recovery of ligamentous knee instability and a valuable adjunct to muscular rehabilitation for post-surgical patients.
References
Liu, S. H., Lunsford, T., Gude, S., & Vangsness Jr, C. T. (1994). Comparison of functional knee braces for control of anterior tibial displacement. Clinical Orthopaedics and Related Research®, 303, 203-210.
Wojtys, E. M., Kothari, S. U., & Huston, L. J. (1996). Anterior cruciate ligament functional brace use in sports. The American journal of sports medicine, 24(4), 539-546.
Jordan, J. M., Helmick, C. G., Renner, J. B., Luta, G., Dragomir, A. D., Woodard, J., ... & Hochberg, M. C. (2009). Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. The Journal of Rheumatology, 36(4), 809-815.
Boden, B. P., Sheehan, F. T., Torg, J. S., & Hewett, T. E. (2010). Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 18(9), 520-527.
Mall, N. A., Chalmers, P. N., Moric, M., Tanaka, M. J., Cole, B. J., Bach Jr, B. R., & Paletta Jr, G. A. (2014). Incidence and trends of anterior cruciate ligament reconstruction in the United States. The American journal of sports medicine, 42(10), 2363-2370.
Karam, M. D., Pugely, A., Callaghan, J. J., & Shurr, D. (2011). Hinged cast brace for persistent flexion contracture following total knee replacement. The Iowa orthopaedic journal, 31, 69.
Beynnon, B. D., Pope, M. H., Wertheimer, C. M., Johnson, R. J., Fleming, B. C., Nichols, C. E., & Howe, J. G. (1992). The effect of functional knee braces on strain on the anterior cruciate ligament in vivo. JBJS, 74(9), 1298-1312.