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Sleeve or Brace: Which One is Better After ACL Repair?

Most surgeons advise sports athletes to wear a brace during play after surgery to repair a torn anterior cruciate ligament (ACL). But which one works best? Should you use a neoprene sleeve or one of the more expensive functional knee braces? Does it matter? Does one give better support or control than the other?

These are the questions posed by researchers from the School of Physical Therapy at the University of Western Ontario in Canada. To find out the answers, they divided a group of ACL patients who had reconstructive surgery into two groups. The first group received a sleeve six weeks after the surgery. The second group was given a brace at the same time.

Everyone wore their supportive device when engaging in any physical activity. This included rehab exercises and any activities that could strain the knee. Running, jumping, twisting, cutting, and pivoting are examples of activities for which the sleeve or brace was worn. In addition, support was required for any activities on uneven ground or involving quick stops and starts.

Results were measured based on perceived quality of life, joint laxity, activity level, and one test called the hop test. The hop test required hopping forward on one foot for a specified distance. Quality of life included work-related concerns, emotional well-being, symptoms, and the ability to participate in leisure time activities and recreational sports.

Patients were followed for two years. In the end, there was no difference in results between the two supportive devices. Athletes wearing the more rigid brace support did not have better results compared to sports participants using the sleeve. The brace group did have greater confidence that their device gave them more support.

The authors suggest that there may be specific subgroups of patients who might benefit from bracing more than others. For example, women under the age of 25 years had higher scores for quality of life when wearing a brace compared with a sleeve. How soon surgery is done after the injury may make a difference.

More studies are needed to identify potential subgroups who should use a support after ACL repair. The type of support may not matter but this should be examined more closely as well.

References: Trevor B. Birmingham, PhD, et al. A Randomized Controlled Trial Comparing the Effectiveness of Functional Knee Brace and Neoprene Sleeve Use After Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. April 2008. Vol. 36. No. 4. Pp. 648-655.

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