Mougin Florian, Begon Mickaël, Desmyttere Gauthier, Bleau Jacinte, Nault Marie-Lyne, Cherni Yosra
School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
UHC Sainte-Justine Research Center Azrieli, Montreal, Quebec, Canada.
Prosthet Orthot Int. 2025 May 9. doi: 10.1097/PXR.0000000000000452.
Anterior cruciate ligament (ACL) injuries frequently lead to altered gait biomechanics and muscle activation patterns, increasing the risk of osteoarthritis. Knee braces are commonly used to address these issues although a lack of consensus remains regarding their clinical benefits. The most recent 3D-printed braces, lighter and personalized, could improve rehabilitation.
To evaluate the effect of a novel custom-made 3D-printed knee brace (Provoke™) in individuals after unilateral ACL reconstruction during walking. The brace incorporates an asymmetrical hinge system aimed at stabilizing the knee joint while minimizing compensatory movements.
Fourteen participants with unilateral ACL reconstruction wore the Provoke™ brace while walking at comfortable and fast paces. Knee kinematics and kinetics and muscular activity (rectus femoris, vastus medialis, and semitendinosus) were assessed with and without the brace. Nonparametric paired t tests were used to assess the biomechanical effect of the brace.
The Provoke™ brace improved knee kinematics, facilitating a more neutral knee position by reducing valgus angles (-1.95°) and increasing flexion angles (+1.14°). In addition, it enhanced muscle activation, particularly of the rectus femoris, suggesting improved quadriceps function. Overall, the Provoke™ brace effectively improves knee function and reduces muscle imbalances in individuals undergoing ACL reconstruction. It may help prevent further injury and reduce the risk of post-traumatic osteoarthritis development. The long-term effects of brace use in ACL rehabilitation must be investigated.
前交叉韧带（ACL）损伤常导致步态生物力学和肌肉激活模式改变，增加患骨关节炎的风险。膝关节支具常用于解决这些问题，但其临床益处仍缺乏共识。最新的3D打印支具更轻且个性化，可能会改善康复效果。
评估一种新型定制3D打印膝关节支具（Provoke™）对单侧ACL重建术后个体行走时的影响。该支具采用不对称铰链系统，旨在稳定膝关节，同时尽量减少代偿性运动。
14名单侧ACL重建的参与者在以舒适和快速步伐行走时佩戴Provoke™支具。在佩戴和不佩戴支具的情况下评估膝关节的运动学、动力学和肌肉活动（股直肌、股内侧肌和半腱肌）。采用非参数配对t检验评估支具的生物力学效果。
Provoke™支具改善了膝关节运动学，通过减小外翻角度（-1.95°）和增加屈曲角度（+1.14°），使膝关节位置更趋于中立。此外，它增强了肌肉激活，尤其是股直肌，表明股四头肌功能得到改善。总体而言，Provoke™支具有效改善了ACL重建个体的膝关节功能，减少了肌肉失衡。它可能有助于预防进一步损伤，降低创伤后骨关节炎发展的风险。必须研究支具在ACL康复中的长期效果。
