Do I Need to Wear a Knee Brace after ACL Surgery?

A knee Bledsoe brace.
A Bledsoe brace is typically worn after ACL surgery to protect your healing ligament.. Brett Sears, PT, 2014

Question: Do I Need to Wear a Knee Brace after ACL Surgery?

I recently injured my knee and an MRI indicates that I have a full thickness tear of my anterior cruciate ligament (ACL). My doctor recommended surgery and gave me a post-operative ACL protocol. I noticed that there is no mention of wearing a brace after the surgery.

Do I need to wear a Bledsoe knee brace after ACL surgery?

Answer:  Historically, surgeons have prescribed knee braces, like a Bledsoe brace, for patients who have had ACL surgery.

 The brace serves to stabilize your knee and allow your ACL to heal properly.  More recently, however, there has been increased scrutiny as to the effectiveness of using a knee brace after ACL surgery.

What Does the Knee Brace Do?

After you have ACL repair surgery, it takes time for the graft that the surgeon used to reconstruct your ACL to heal.  During the healing process, which takes anywhere from 8-10 weeks, the new ligament is in danger of rupturing.  Rupture of the ACL graft may occur if forces are placed on your knee that the graft cannot tolerate.

Wearing a knee brace, like a hinged Bledsoe brace, after ACL surgery is thought to protect the graft as it is healing.  The brace helps to control the motion of your knee and limit the amount of range of motion around your knee.  This is thought to help decrease force through the ACL graft and protect it while it heals.

What Does the Evidence Show?

A study published in June of 2013 examined the long term effects of using a knee brace after ACL surgery versus using no brace at all.

 The researchers randomized 64 patients who had ACL surgery into 2 groups.  One group used a brace after surgery, and the other group did not use a post-operative brace after their ACL surgery.

Four years after surgery, the researchers measured ACL ligament integrity, pain levels, and x-ray pictures in each patient who had surgery.

 They found that there was no difference in ligament integrity between groups.

There was one significant difference between the brace group when compared to the no-brace group.  The patients who did not use a knee brace after surgery reported less pain during sports or heavy physical work activites.  There also was no reported injuries in the no-brace group as compared to the brace group.

What if My Surgeon Prescribes a Bledsoe Brace for Me?

Every person is different, and surgery for an ACL repair can be complicated.  Different surgical techniques or different ACL grafts may be used, and complications may occur during your surgery.  For these reasons, your doctor may recommend you wear a brace after your surgery.  Your best bet is to follow your doctor's advice, but have a discussion with your doctor to understand the need for your brace.

After your ACL surgery, you may benefit from physical therapy to help you regain knee strength and range of motion and to return to normal activity and function.

  Your PT can also teach you to properly wear and fit your brace if your doctor recommends you use one.

For years, surgeons have prescribed a knee brace for their patients following ACL repair surgery.  More recently, evidence indicates that this may not be necessary.  If you have had ACL surgery, talk with your doctor about weather or not you need a brace following your procedure.

Source: Mayr, H. O., et al.  "Brace or no-brace after ACL graft? Four-year results of a prospective clinical trial."  Knee Surg Sports Truamtol Arthrosc. June  2013.

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