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The biomechanics of lateral knee bracing

Part I: Response of the valgus restraints to loading

Salt Lake Knee and Sports Medicine Clinic

E. Paul France, PhD

Salt Lake Knee and Sports Medicine Clinic, Department of Orthopaedics, University of Utah Medical Center, Salt Lake City, Utah

Thomas D. Rosenberg, MD

Salt Lake Knee and Sports Medicine Clinic

Gopal Jayaraman, PhD

Department of Mechanical Engineering, Michigan Technological University, Houghton, Michigan

Paul J. Abbott, MD

Salt Lake Knee and Sports Medicine Clinic

Jose Jaen, MD

Salt Lake Knee and Sports Medicine Clinic

To better understand the role of preventive knee braces in injury prevention, a biomechanical study using fresh frozen cadaveric knees (N = 18) was conducted. Liga ment tensions and joint displacements were measured at static, nondestructive valgus forces as well as low- rate destructive forces. After quantifying and establish ing individual ligament contributions to valgus restrain ing function, knees were then braced with two different laterally applied preventive braces, the McDavid Knee Guard and the Omni Anderson Knee StabIer.The effects of lateral bracing were analyzed according to valgus force, joint line opening, and ligament tensions.

Valgus applied forces, with or without braces, consis tently produced medial collateral ligament (MCL) disrup tions at ligament tensions surprisingly higher than the anterior cruciate ligament (ACL) and higher than or equal to the posterior cruciate ligament (PCL). Although large joint displacements were necessary for complete ligament failure, bundle disruption in the MCL, ACL, and PCL was noted at much smaller joint openings. In Part I of this study, no significant protection could be documented with the two preventive braces used. Also, four potentially adverse effects were noted: MCL pre load, center axis shift, premature joint line contact, and brace slippage.

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