Smith Sean D, Laprade Robert F, Jansson Kyle S, Arøen Asbjørn, Wijdicks Coen A
Department of BioMedical Engineering, Steadman Philippon Research Institute (SPRI), 181W. Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
Knee Surg Sports Traumatol Arthrosc. 2014 May;22(5):1131-41. doi: 10.1007/s00167-013-2514-z. Epub 2013 Apr 27.
Functional braces are commonly prescribed to treat anterior cruciate ligament (ACL) injury. The results of the existing literature on functional brace use are mixed. The purpose of this study was to evaluate the history and current state of functional ACL bracing and to identify design criteria that could improve upon current bracing technologies.
A literature search was performed through the PubMed MEDLINE database in April 2013 for the keywords "anterior cruciate ligament" and "brace". Articles published between January 1, 1980, and April 4, 2013, were retrieved and reviewed. Current functional braces used to treat ACL injury were identified. The function of the native ACL was carefully studied to identify design requirements that could improve upon current bracing technologies.
Biomechanical evaluations of functional brace effects at time zero have been mixed. Functional brace use reportedly does not improve long-term patient outcomes following ACL reconstruction, but has been shown to reduce subsequent injury rates while skiing in both ACL-deficient and reconstructed skiers. In situ force in the ACL varies with flexion angle and activity. Currently, no brace has been designed and validated to replicate the force-flexion behavior of the native ACL.
Biomechanical and clinical evidence suggests current functional bracing technologies do not sufficiently restore normal biomechanics to the ACL-deficient knee, protect the reconstructed ACL, and improve long-term patient outcomes. Further research into a functional brace designed to apply forces to the knee joint similar in magnitude to the native ACL should be pursued.
III.
功能性支具常用于治疗前交叉韧带（ACL）损伤。现有关于使用功能性支具的文献结果不一。本研究的目的是评估功能性ACL支具的历史和现状，并确定能够改进当前支具技术的设计标准。
2013年4月通过PubMed MEDLINE数据库进行文献检索，关键词为“前交叉韧带”和“支具”。检索并回顾了1980年1月1日至2013年4月4日期间发表的文章。确定了目前用于治疗ACL损伤的功能性支具。仔细研究了天然ACL的功能，以确定能够改进当前支具技术的设计要求。
对功能性支具在初始时刻效果的生物力学评估结果不一。据报道，使用功能性支具并不能改善ACL重建术后患者的长期预后，但已显示在ACL损伤和重建的滑雪者中，它能降低滑雪时后续的损伤率。ACL中的原位力随屈曲角度和活动而变化。目前，尚未设计并验证出能复制天然ACL力-屈曲行为的支具。
生物力学和临床证据表明，当前的功能性支具技术不能充分恢复ACL损伤膝关节的正常生物力学，保护重建的ACL，并改善患者的长期预后。应进一步研究设计一种能向膝关节施加与天然ACL大小相似力的功能性支具。
III级。
