FUNCTIONAL ACL BRACING: A SURVEY OF CURRENT OPINION AND PRACTICE

Introduction: The results of most studies designed to prove the efficacy of functional ACL bracing have been equivocal. Therefore, in reviewing our practice, we felt it would be helpful to know the practice and philosophy of our colleagues.

Purpose: The purpose of this study was to examine current ACL bracing practice and philosophy amongst orthopaedic sports medicine physicians.

Methods: The survey population consisted of members of an orthopaedic society for sports medicine (N=125), and alumni of a sports medicine fellowship (N=80). The physicians were questioned about their practices regarding non-surgical and post-reconstruction patients; preference for custom vs. off-the-shelf braces; weight given to various considerations regarding bracing decisions; length of time patients are kept in functional braces after reconstruction; and whether the physician's practices with regard to functional brace prescription had changed recently.

Results/Discussion: Overall response rate was 57% (114). Most of the physicians surveyed use functional braces for their ACL-deficient and reconstruction patients. Further, there is a definite preference for custom, rather than off-the-shelf, braces. Most respondents reported 9 months as the length of time they brace after reconstruction.

Finally, among the respondents, 36% reported having made recent changes in their functional brace prescription practices, which included bracing less often, for less time or using more off-the-shelf braces. There was no effort in this study to determine the best practice style and philosophy for functional bracing, or whether one physician's brace preferences result in better patient outcomes than another's. We feel that the strong response to this single mailing shows a high level of interest in this topic among orthopaedic sports medicine physicians. It is challenging but necessary to study functional bracing parameters in an effort to provide some rationale for bracing regimens.

1994 Decoster LC, Vailas JC: Functional ACL bracing: Am J Orthopedics, Volume 24(11), November 1995, 838-842.