The Effectiveness of Prophylactic Knee Braces in Preventing ACL Injuries
The use of prophylactic knee braces to prevent knee injuries has long been a contentious area of research. The best study to date of prophylactic knee braces and ACL injury remains a prospective, randomized study of 1396 cadets playing intramural tackle football at the U.S. Military Academy (Sitler et al. 1990). This study showed that prophylactic knee brace use did not significantly decrease the severity of ACL and MCL injuries. There was, however, a trend toward a reduced rate of less severe ACL and MCL injuries in athletes who used braces (Sitler et al. 1990).
On the basis of the data published in that paper, we compute that the rate of ACL injury in the nonbraced cadets was 3.0 times higher (95%CI: 1.0-9.2) than in braced cadets. It should be noted that the number of ACL injuries was small. Only 16 ACL injuries occurred: four in the braced and 12 in the nonbraced condition. Other large epidemiologic studies conducted to date have focused on the effectiveness of prophylactic braces in reducing MCL injuries in the sport of football; however, these investigations have not dealt with the effect of bracing on the reduction of ACL injuries (Albright et al. 1994a, 1994b; Hewson, Mendini, and Wang 1986; Teitz et al. 1987). The efficacy of prophylactic knee braces in preventing ACL disruptions remains an unanswered question (Najibi and Albright 2005).