The effect of unloader knee braces on medial meniscal strain

Abstract

Background: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity. Objectives: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states. Study design: Combined in vivo/in vitro study. Methods: In vivo knee kinematics and muscle force profiles from a healthy individual performing single/doubleleg squats and walking motions were simulated on 10 cadaveric specimens using a dynamic knee simulator system. Simulations were performed on knees in unbraced and braced scenarios, with and without the anterior cruciate ligament. Anterior and posterior medial meniscal strains were measured. Results: Two different braces each showed a significant reduction in the posteromedial meniscal strain (p\u2009⩽\u20090.01) in an intact anterior cruciate ligament state. Neither brace mirrored this result for the anteromedial strain (p\u2009>\u20090.05). In the deficient anterior cruciate ligament state, the braces had no significant effect on strain (p\u2009>\u20090.05). Conclusion: Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees. Clinical relevance Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.