METHODS: A PubMed search for CPGs for the use of braces following ACL injury or reconstruction was performed. CPGs on the treatment of ACL injuries with sufficient attention to postoperative braces were included in this scoping review. The references used for supporting the specific CPG recommendations were reviewed. Specific indications for brace use including brace type, period of use following surgery and activities requiring brace use were collected.
RESULTS: Six CPGs were identified and included this this review. Three randomised trials provided the evidence for recommendations on functional brace use following ACL reconstruction in the six CPGs. Functional ACL braces were the primary focus of the three randomised trials, although extension braces (postoperative knee immobilisers) were also discussed. A novel dynamic ACL brace category has been described, although included CPGs did not provide guidance on this brace type.
CONCLUSIONS: Guidance on the use of functional ACL braces following ACL reconstruction is provided in six CPGs supported by three randomised trials. However, the brace protocols and patient compliance in the randomised trials render these CPGs inadequate for providing guidance on the use of functional ACL braces in the general and high-risk patient populations when returning to sport after ACL reconstruction. Functional ACL braces are commonly utilised during the course of ACL injury treatment although there is presently limited evidence supporting or refuting the routine use of these braces. Future studies are, therefore, necessary in order to provide guidance on the use of functional and dynamic ACL braces in high-risk patient populations.
METHODS: Level II.
方法:PubMed对ACL损伤或重建后使用支架的CPG进行了搜索。本范围审查中包括了关于ACL损伤治疗的CPG,并充分注意术后支架。审查了用于支持具体CPG建议的参考文献。支具使用的具体指示,包括支具类型,收集了手术后的使用期和需要使用支具的活动。
结果:确定了6个CPG,并纳入了这篇综述。三项随机试验为六个CPG中ACL重建后使用功能支具的建议提供了证据。功能性ACL支架是三项随机试验的主要焦点,虽然延长支架(术后膝关节固定)也进行了讨论。已经描述了一种新颖的动态ACL支撑类别,尽管包含的CPG没有提供关于这种支撑类型的指导。
结论:关于ACL重建后使用功能性ACL支架的指南在6个CPG中提供,由3个随机试验支持。然而,随机试验中的支具方案和患者依从性使得这些CPG不足以为一般和高危患者人群在ACL重建后恢复运动时使用功能性ACL支具提供指导.功能性ACL支架通常在ACL损伤治疗过程中使用,尽管目前有有限的证据支持或反驳这些支架的常规使用。未来的研究是,因此,为在高风险患者人群中使用功能性和动态ACL矫正器提供指导。
方法:二级。