Biomechanical evaluation of a novel dynamic posterior cruciate ligament brace. (March 2016)

• Record Type: Journal Article
• Authors: Heinrichs, Christian H.; Schmoelz, Werner; Mayr, Raul; Keiler, Alexander; Schöttle, Philip B.; Attal, René
• Is Part Of: Clinical biomechanics. Volume 33(2016)
• Page Start: 20
• Page End: 25
• Publication Date: 2016-03
• Subjects: Posterior cruciate ligament -- Brace -- Orthopedic biomechanics -- Posterior tibial translation -- Stress radiographs -- PCL reconstruction; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2016.02.001
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Use of a rigid brace or cast immobilization is recommended in conservative treatment or postoperative rehabilitation after a posterior cruciate ligament injury. To prevent the loss of knee joint function and muscle activity often associated with this, a flexible knee brace has been developed that allows an adjustable anteriorly directed force to be applied to the calf in order to prevent posterior tibial translation. The purpose of this biomechanical study was to evaluate the impact of this novel dynamic brace on posterior tibial translation after posterior cruciate ligament injury and reconstruction. Methods: A Telos stress device was used to provoke posterior tibial translation in seven human lower limb specimens, and stress radiographs were taken at 90° of knee flexion. Posterior tibial translation was measured in the native knees with an intact posterior cruciate ligament; after arthroscopic posterior cruciate ligament dissection with and without a brace; and after posterior cruciate ligament reconstruction with and without a brace. The force applied with the brace was measured using a pressure sensor. Findings: Posterior tibial translation was significantly reduced ( P = 0.032) after application of the brace with an anteriorly directed force of 50 N to the knees with the dissected posterior cruciate ligament. The brace also significantly reduced posterior tibial translation after posterior cruciate ligament reconstruction in comparison with reconstructed knees without a brace ( P = 0.005). Interpretation: Posterior tibial translation was reduced to physiological values using this dynamic brace system that allows an anteriorly directed force to be applied to the calf. Highlights: Evaluation of a novel posterior cruciate ligament brace on posterior tibial translation Dynamic brace applies an adjustable anteriorly directed force to the calf In vitro measurement of posterior tibial translation for the native knee, after posterior cruciate ligament dissection and reconstruction Posterior tibial translation could be reduced to physiological values