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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2011

01-08-2011 | Knee

Knee braces can decrease tibial rotation during pivoting that occurs in high demanding activities

Authors: Dimitrios Giotis, Vasilios Tsiaras, Stavros Ristanis, Franceska Zampeli, Grigoris Mitsionis, Nicholas Stergiou, Anastasios D. Georgoulis

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2011

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Abstract

Purpose

The purpose of this study was to investigate whether knee braces could effectively decrease tibial rotation during high demanding activities.

Methods

Using an in vivo three-dimensional kinematic analysis, 21 physically active, healthy, male subjects were evaluated. Each subject performed two tasks that were used extensively in the literature because they combine increased rotational and translational loads on the knee, (1) descending from a stair and subsequent pivoting and (2) landing from a platform and subsequent pivoting under three conditions: (A) wearing a prophylactic brace (braced), (B) wearing a patellofemoral brace (sleeved), and (C) unbraced condition.

Results

In the first task, tibial rotation during the pivoting phase was significantly decreased in the braced condition as compared to the sleeved condition (P = 0.019) and the non-braced condition (P = 0.002). In the second task, the same variable was significantly decreased in the braced condition as compared to the sleeved (P = 0.001) and the unbraced condition (P < 0.001). The sleeved condition also produced significantly decreased tibial rotation with respect to the unbraced condition (P = 0.021).

Conclusions

Bracing decreased tibial rotation in activities where increased translational and rotational forces were applied. Because knee braces decreased tibial rotation, they can possibly be used with ACL-reconstructed and ACL-deficient patients to prevent such problems.

Level of evidence

Case–control study, Level III.
Literature
1.
go back to reference Andriacchi TP, Andersson GB, Fernier RW et al (1980) A study of lower-limb mechanics during stair-climbing. J Bone Joint Surg Am 62:749–757PubMed Andriacchi TP, Andersson GB, Fernier RW et al (1980) A study of lower-limb mechanics during stair-climbing. J Bone Joint Surg Am 62:749–757PubMed
2.
go back to reference Aroll B, Ellis-Pegler E, Edmonds A, Sutcliffe G (1997) Patellofemoral pain syndrome: a critical review of the clinical trials on nonoperative therapy. Am J Sports Med 25:207–212CrossRef Aroll B, Ellis-Pegler E, Edmonds A, Sutcliffe G (1997) Patellofemoral pain syndrome: a critical review of the clinical trials on nonoperative therapy. Am J Sports Med 25:207–212CrossRef
3.
go back to reference Bedi A, Musahl V, O`Loughlin P, Maak T, Citak M, Dixon P, Pearle AD (2010) A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med 38:1788–1794PubMedCrossRef Bedi A, Musahl V, O`Loughlin P, Maak T, Citak M, Dixon P, Pearle AD (2010) A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med 38:1788–1794PubMedCrossRef
4.
go back to reference Beynnon BD, Fleming BC, Churchill DL, Brown D (2003) The effect of anterior cruciate ligament deficiency and functional bracing on translation of the tibia relative to the femur during nonweightbearing and weightbearing. Am J Sports Med 31:99–105PubMed Beynnon BD, Fleming BC, Churchill DL, Brown D (2003) The effect of anterior cruciate ligament deficiency and functional bracing on translation of the tibia relative to the femur during nonweightbearing and weightbearing. Am J Sports Med 31:99–105PubMed
5.
go back to reference Beynnon BD, Johnson RJ, Fleming BC, Pleura GD, Renstrom PA, Nichols CE, Pope MH (1997) The effect of functional knee bracing on the anterior cruciate ligament in the weightbearing and non weightbearing knee. Am J Sports Med 25:353–359PubMedCrossRef Beynnon BD, Johnson RJ, Fleming BC, Pleura GD, Renstrom PA, Nichols CE, Pope MH (1997) The effect of functional knee bracing on the anterior cruciate ligament in the weightbearing and non weightbearing knee. Am J Sports Med 25:353–359PubMedCrossRef
6.
go back to reference Beynnon BD, Pope MH, Wertheimer CM, Johnson RJ, Fleming BC, Nichols CE, Howe JG (1992) The effect of functional knee-braces on strain on the anterior cruciate ligament in vivo. J Bone Joint Surg Am 74:1298–1312PubMed Beynnon BD, Pope MH, Wertheimer CM, Johnson RJ, Fleming BC, Nichols CE, Howe JG (1992) The effect of functional knee-braces on strain on the anterior cruciate ligament in vivo. J Bone Joint Surg Am 74:1298–1312PubMed
7.
go back to reference Branch TP (1989) Dynamic EMG analysis of anterior cruciate deficient legs with and without bracing during cutting. Am J Sports Med 17:35–41PubMedCrossRef Branch TP (1989) Dynamic EMG analysis of anterior cruciate deficient legs with and without bracing during cutting. Am J Sports Med 17:35–41PubMedCrossRef
8.
go back to reference Cawley PW, France EP, Paulos LE (1989) Comparison of rehabilitative knee braces. A biomechanical investigation. Am J Sports Med 17:141–146PubMedCrossRef Cawley PW, France EP, Paulos LE (1989) Comparison of rehabilitative knee braces. A biomechanical investigation. Am J Sports Med 17:141–146PubMedCrossRef
9.
go back to reference Cawley PW, France EP, Paulos LE (1991) The current state of functional knee bracing research. A review of the literature. Am J Sports Med 19:226–233PubMedCrossRef Cawley PW, France EP, Paulos LE (1991) The current state of functional knee bracing research. A review of the literature. Am J Sports Med 19:226–233PubMedCrossRef
10.
go back to reference Chambers HG, Sutherland DH (2002) A practical guide to gait analysis. J Am Acad Orthop Surg 10:222–231PubMed Chambers HG, Sutherland DH (2002) A practical guide to gait analysis. J Am Acad Orthop Surg 10:222–231PubMed
11.
go back to reference Cook FF, Tibone JE, Redfern FC (1989) A dynamic analysis of a functional brace for anterior cruciate ligament insufficiency. Am J Sports Med 17:519–524PubMedCrossRef Cook FF, Tibone JE, Redfern FC (1989) A dynamic analysis of a functional brace for anterior cruciate ligament insufficiency. Am J Sports Med 17:519–524PubMedCrossRef
12.
go back to reference Davis R, Ounpuu S, Tyburski D et al (1991) A gait analysis data collection and reduction technique. Hum Move Sci 10:575–587CrossRef Davis R, Ounpuu S, Tyburski D et al (1991) A gait analysis data collection and reduction technique. Hum Move Sci 10:575–587CrossRef
13.
go back to reference Decker M, Torry M, Nooman T, Riviere A, Sterett W (2002) Landing adaptations after ACL reconstruction. Med Sci Sports Exerc 34:1408–1413PubMedCrossRef Decker M, Torry M, Nooman T, Riviere A, Sterett W (2002) Landing adaptations after ACL reconstruction. Med Sci Sports Exerc 34:1408–1413PubMedCrossRef
14.
go back to reference DeVita P, Hunter PB, Skelly WA (1992) Effects of a functional knee brace on the biomechanics of running. Med Sci Sports Exerc 24:797–806PubMed DeVita P, Hunter PB, Skelly WA (1992) Effects of a functional knee brace on the biomechanics of running. Med Sci Sports Exerc 24:797–806PubMed
15.
go back to reference France EP, Paulos LE (1994) Knee bracing. J Am Acad Orthop Surg 2:281–287PubMed France EP, Paulos LE (1994) Knee bracing. J Am Acad Orthop Surg 2:281–287PubMed
16.
go back to reference Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate deficient and reconstructed knee during walking. Am J Sports Med 31:75–79PubMed Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate deficient and reconstructed knee during walking. Am J Sports Med 31:75–79PubMed
17.
go back to reference Georgoulis AD, Ristanis S, Chouliaras V, Moraiti C, Stergiou N (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res 454:89–94PubMedCrossRef Georgoulis AD, Ristanis S, Chouliaras V, Moraiti C, Stergiou N (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res 454:89–94PubMedCrossRef
18.
go back to reference Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144PubMedCrossRef Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144PubMedCrossRef
19.
go back to reference Harner CD, Poehling GG (2004) Double bundle or double trouble? Arthroscopy 20:1015–1025CrossRef Harner CD, Poehling GG (2004) Double bundle or double trouble? Arthroscopy 20:1015–1025CrossRef
20.
go back to reference James CR, Bates BT, Dufek JS (2003) Classification and comparison of biomechanical response strategies for accommodating landing impact. J Appl Biomech 19:106–118PubMed James CR, Bates BT, Dufek JS (2003) Classification and comparison of biomechanical response strategies for accommodating landing impact. J Appl Biomech 19:106–118PubMed
21.
go back to reference Kanamori A, Zeminski J, Rudi TW, Li G, Fu FH, Woo SL (2002) The effect of axial tibial torque on the function of the anterior cruciate ligament: a biomechanical study of a simulated pivot shift test. Arthroscopy 18:394–398PubMedCrossRef Kanamori A, Zeminski J, Rudi TW, Li G, Fu FH, Woo SL (2002) The effect of axial tibial torque on the function of the anterior cruciate ligament: a biomechanical study of a simulated pivot shift test. Arthroscopy 18:394–398PubMedCrossRef
22.
go back to reference Knutzen KM, Bates BT, Hamill J (1983) Electrogoniometry of post-surgical knee bracing in running. Am J Phys Med 62:172–181PubMed Knutzen KM, Bates BT, Hamill J (1983) Electrogoniometry of post-surgical knee bracing in running. Am J Phys Med 62:172–181PubMed
23.
go back to reference Kondo E, Merican AM, Yasuda K, Amis AA (2010) Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle. Am J Sports Med 38:1349–1358PubMedCrossRef Kondo E, Merican AM, Yasuda K, Amis AA (2010) Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle. Am J Sports Med 38:1349–1358PubMedCrossRef
24.
go back to reference Kramer JF, Dubowitz T, Fowler P, Schachter C, Birmingham T (1997) Functional knee braces and dynamic performance: a review. Clin J Sport Med 7:32–39PubMedCrossRef Kramer JF, Dubowitz T, Fowler P, Schachter C, Birmingham T (1997) Functional knee braces and dynamic performance: a review. Clin J Sport Med 7:32–39PubMedCrossRef
25.
go back to reference Lucchetti L, Cappozzo A, Cappello A, Crose UD (1998) Skin movement artefact assessment and compensation in the estimation of knee-joint kinematics. J Biomech 31:977–984PubMedCrossRef Lucchetti L, Cappozzo A, Cappello A, Crose UD (1998) Skin movement artefact assessment and compensation in the estimation of knee-joint kinematics. J Biomech 31:977–984PubMedCrossRef
26.
go back to reference McNair P, Marshall R (1994) Landing characteristics in subjects with normal and anterior cruciate ligament deficient knee joints. Arch Phys Med Rehabil 75:584–589PubMed McNair P, Marshall R (1994) Landing characteristics in subjects with normal and anterior cruciate ligament deficient knee joints. Arch Phys Med Rehabil 75:584–589PubMed
27.
go back to reference Paluska SA, McKeag MD (2000) Knee braces: current evidence and clinical recommendations for their use. Am Fam Physician 61:411–418PubMed Paluska SA, McKeag MD (2000) Knee braces: current evidence and clinical recommendations for their use. Am Fam Physician 61:411–418PubMed
28.
go back to reference Perlau R, Frank C, Fick G (1995) The effect of elastic bandages on human knee proprioception in the uninjured population. Am J Sports Med 23:251–255PubMedCrossRef Perlau R, Frank C, Fick G (1995) The effect of elastic bandages on human knee proprioception in the uninjured population. Am J Sports Med 23:251–255PubMedCrossRef
29.
go back to reference Ramsey DK, Wretenberg PF, Lamontagne M, Nιmeth G (2003) Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clin Biomech 18:28–34CrossRef Ramsey DK, Wretenberg PF, Lamontagne M, Nιmeth G (2003) Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clin Biomech 18:28–34CrossRef
30.
go back to reference Reinschmidt C, Bogert AVD, Nigg B, Lundberg A, Murphy N (1997) Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech 30:729–732PubMedCrossRef Reinschmidt C, Bogert AVD, Nigg B, Lundberg A, Murphy N (1997) Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech 30:729–732PubMedCrossRef
31.
go back to reference Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N, Georgoulis AD (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting and descending stairs. Knee Surg Sports Traumatol Arthrosc 11:360–365PubMedCrossRef Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N, Georgoulis AD (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting and descending stairs. Knee Surg Sports Traumatol Arthrosc 11:360–365PubMedCrossRef
32.
go back to reference Ristanis S, Stergiou N, Patras K, Tsepis E, Moraiti C, Georgoulis AD (2006) Follow up evaluation 2 years after ACL reconstruction with bone—patellar tendon—bone graft shows that excessive tibial rotation persists. Clin J Sport Med 16:111–116PubMedCrossRef Ristanis S, Stergiou N, Patras K, Tsepis E, Moraiti C, Georgoulis AD (2006) Follow up evaluation 2 years after ACL reconstruction with bone—patellar tendon—bone graft shows that excessive tibial rotation persists. Clin J Sport Med 16:111–116PubMedCrossRef
33.
go back to reference Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high demanding activities is not restored by ACL reconstruction. Arthroscopy 21:1323–1329PubMedCrossRef Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high demanding activities is not restored by ACL reconstruction. Arthroscopy 21:1323–1329PubMedCrossRef
34.
go back to reference Sitler M, Ryan J, Hopkinson W, Wheeler J, Santomier J, Kolb R, Polley D (1990) The efficacy of a prophylactic knee brace to reduce knee injuries in football. A prospective, randomized study at West Point. Am J Sports Med 18:310–315PubMedCrossRef Sitler M, Ryan J, Hopkinson W, Wheeler J, Santomier J, Kolb R, Polley D (1990) The efficacy of a prophylactic knee brace to reduce knee injuries in football. A prospective, randomized study at West Point. Am J Sports Med 18:310–315PubMedCrossRef
35.
go back to reference Stergiou N, Bates BT, James SL (1999) Asynchrony between subtalar and knee joint function during running. Med Sci Sports Exerc 31:1645–1655PubMedCrossRef Stergiou N, Bates BT, James SL (1999) Asynchrony between subtalar and knee joint function during running. Med Sci Sports Exerc 31:1645–1655PubMedCrossRef
36.
go back to reference Teitz CC, Hermanson BK, Kronmal RA, Diehr PH (1987) Evaluation of the use of braces to prevent injury to the knee in collegiate football players. J Bone Joint Surg Am 69:2–9PubMed Teitz CC, Hermanson BK, Kronmal RA, Diehr PH (1987) Evaluation of the use of braces to prevent injury to the knee in collegiate football players. J Bone Joint Surg Am 69:2–9PubMed
37.
go back to reference Theoret D, Lamontagne M (2006) Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running. Knee Surg Sports Traumatol Arthrosc 11:555–563CrossRef Theoret D, Lamontagne M (2006) Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running. Knee Surg Sports Traumatol Arthrosc 11:555–563CrossRef
38.
go back to reference Tsai AG, Wijdicks CA, Walsh MP, Laprade RF (2010) Comparative kinematic evaluation of all-inside single-bundle and double-bundle anterior cruciate ligament reconstruction: a biomechanical study. Am J Sports Med 38:263–272PubMedCrossRef Tsai AG, Wijdicks CA, Walsh MP, Laprade RF (2010) Comparative kinematic evaluation of all-inside single-bundle and double-bundle anterior cruciate ligament reconstruction: a biomechanical study. Am J Sports Med 38:263–272PubMedCrossRef
39.
go back to reference Vailas JC, Pink M (1993) Biomechanical effects of functional knee bracing. Practical implications. Sports Med 15:210–218PubMedCrossRef Vailas JC, Pink M (1993) Biomechanical effects of functional knee bracing. Practical implications. Sports Med 15:210–218PubMedCrossRef
40.
go back to reference Vergis A, Gillquist J (1998) Sagittal plane translation of the knee during stair walking. Comparison of healthy and anterior cruciate ligament-deficient subjects. Am J Sports Med 26:841–846PubMed Vergis A, Gillquist J (1998) Sagittal plane translation of the knee during stair walking. Comparison of healthy and anterior cruciate ligament-deficient subjects. Am J Sports Med 26:841–846PubMed
41.
go back to reference Wojtys EM, Kothari SU, Huston LJ (1996) Anterior cruciate ligament functional brace in sports. Am J Sports Med 24:539–546PubMedCrossRef Wojtys EM, Kothari SU, Huston LJ (1996) Anterior cruciate ligament functional brace in sports. Am J Sports Med 24:539–546PubMedCrossRef
42.
go back to reference Wojtys EM, Loubert PV, Samson SY, Viviano DM (1990) Use of a knee-brace for control of tibial translation and rotation. A comparison, in cadavera, of available models. J Bone Joint Surg Am 72:1323–1329PubMed Wojtys EM, Loubert PV, Samson SY, Viviano DM (1990) Use of a knee-brace for control of tibial translation and rotation. A comparison, in cadavera, of available models. J Bone Joint Surg Am 72:1323–1329PubMed
43.
go back to reference Wright RW, Fetzer GB (2007) Bracing after ACL reconstruction. A systematic review. Clin Orthop Relat Res 455:162–168PubMedCrossRef Wright RW, Fetzer GB (2007) Bracing after ACL reconstruction. A systematic review. Clin Orthop Relat Res 455:162–168PubMedCrossRef
Metadata
Title
Knee braces can decrease tibial rotation during pivoting that occurs in high demanding activities
Authors
Dimitrios Giotis
Vasilios Tsiaras
Stavros Ristanis
Franceska Zampeli
Grigoris Mitsionis
Nicholas Stergiou
Anastasios D. Georgoulis
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1454-8

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