Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee

Ramsey, Dan K; Lamontagne, Mario; Wretenberg, Per F; Valentin, Anders; Engström, Björn; Németh, Gunnar

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Volume 16, Issue 1 , Pages 61-70, January 2001

Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee

Dan K Ramsey
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Department of Surgical Sciences, Section for Orthopaedics, Karolinska Institute, Stockholm, Sweden
- Corresponding author. Address: Motor control Laboratory, Astrid Lindgren Children's Hospital, Q6:01077, 171 76 Stockholm, Sweden
Mario Lamontagne
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
Per F Wretenberg
- Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden
Anders Valentin
- Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden
Björn Engström
- Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden
Gunnar Németh
- Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden

Received 15 November 1999; accepted 17 August 2000.

Abstract

Objective. To describe three-dimensional tibial and femoral movements in vivo and examine the effect of a brace on knee kinematics during moderate to intense activity.

Design. Skeletal kinematics of anterior cruciate ligament deficient knees was measured with and without braces during moderate to intense activity.

Background. Invasive markers implanted into the tibia and femur are the most accurate means to directly measure skeletal motion and may provide a more sensitive measure of the differences between brace conditions.

Methods. Steinmann traction pins were implanted into the femur and tibia of four subjects having a partial or complete anterior cruciate ligament rupture. Non-braced and braced conditions were randomly assigned and subjects jumped for maximal horizontal distance to sufficiently stress the anterior cruciate ligament.

Results. Intra-subject peak vertical force and posterior shear force were generally consistent between conditions. Intra-subject kinematics was repeatable but linear displacements between brace conditions were small. Differences in angular and linear skeletal motion were observed across subjects. Bracing the anterior cruciate ligament deficient knee resulted in only minor kinematic changes in tibiofemoral joint motion.

Conclusion. In this study, no consistent reductions in anterior tibial translations were observed as a function of the knee brace tested.

Relevance

Investigations have reported that knee braces fail when high loads are encountered or when load is applied in an unpredictable manner. Questions remain regarding tibiofemoral joint motion, in particular linear displacements. The pin technique is a means for direct skeletal measurement and may provide a more sensitive measure of the differences between brace conditions.

Keywords: Knee joint, Tibiofemoral kinematics, Three-dimensional kinematics, Anterior cruciate ligament, ACL injury, Knee brace, Knee instability, Bone pin