{"id":3582,"date":"2023-06-22T18:48:40","date_gmt":"2023-06-22T18:48:40","guid":{"rendered":"https:\/\/andreasphysioblog.com\/?p=3582"},"modified":"2023-11-25T19:05:40","modified_gmt":"2023-11-25T19:05:40","slug":"acl-cross-brace-protocol","status":"publish","type":"post","link":"https:\/\/andreasphysioblog.com\/?p=3582","title":{"rendered":"ACL Cross Brace protocol"},"content":{"rendered":"\n

Thanks to Dr Jane Rooney for an informative lecture about their recent publication \u201cHealing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical management with the Cross Bracing Protocol\u201d (Filbay, et al. 2023)<\/a> which found that in select complete ACL tears up to 90% may show evidence of healing on MRI at 3 months post-injury.<\/p>\n\n\n\n

They found a better potential for those patients who had a more displaced rupture (ACL tissue is within the intercondylar notch) compare to non-displaced.<\/p>\n\n\n\n

Rehabilitation aims during Cross Bracing protocol.<\/p>\n\n\n\n

Bracing phase: week 0- 12 weeks<\/p>\n\n\n\n

\u2043 Encourage optimal healing of the injure
ACL whilst minimising 1) joint stiffness\/ pain 2) local and global muscle atrophy and 3) DVT risk from immobilization,<\/p>\n\n\n\n

It involves an initial period of 6 weeks of non-weight bearing with crutches or a mobility scooter in a range of motion knee brace.<\/p>\n\n\n\n

Weeks 1-4 the knee is locked at 90 degrees of flexion 24\/7. Non weightbearing with crutches\/ wheelchair\/ scooter. This is the most challenging time for patients especially if it is the car driving leg.<\/p>\n\n\n\n

Week 5 the brace is then opened between 90 to 60 degrees of knee flexion to allow some movement. Still non weight bearing.<\/p>\n\n\n\n

Week 6 the brace is opened further to allow movement between 90 and 45 degrees.<\/p>\n\n\n\n

Weeks 7 full knee flexion and weight bearing as tolorated with crutches.<\/p>\n\n\n\n

Week 8: Still full flexion allow full weight-bearing with crutches.<\/p>\n\n\n\n

Week 9: -10 to flexion to limits . Still full weight-bearing with crutches.<\/p>\n\n\n\n

Week 13\/14: Removal of Brace. Full weight bearing<\/p>\n\n\n\n

Main problems post 12:<\/p>\n\n\n\n

\u2022 Joint arthrofibrosis; knee ext stiffness, PFJ stiffness\/ pain<\/p>\n\n\n\n

\u2022 Quads\/ hamstrings\/calf atrophy + plus other lower limb muscle weakness ipsilateral and contralateral leg.<\/p>\n\n\n\n

\u2022 Gait disturbance especially terminal knee extension control<\/p>\n\n\n\n

\u2022 \ufeffBalance and neuromuscular control deficits<\/p>\n\n\n\n

\u2022 \ufeffcardiovascular deconditioning<\/p>\n\n\n\n

\u2022 In addition to usual impairments post ACL non-op management and indeed ACLR<\/p>\n\n\n\n

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Stephanie Filbay Aspetar ACL Conference <\/p>\n\n\n\n

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Thanks to Dr Jane Rooney for an informative lecture about their recent publication \u201cHealing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical management with the Cross Bracing Protocol\u201d (Filbay, et al. 2023) which found that in select complete ACL tears up to 90% may show evidence of healing on MRI at […]<\/p>\n","protected":false},"author":81,"featured_media":3584,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","om_disable_all_campaigns":false,"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[155,354,198,382,4,1],"tags":[156,37],"class_list":["post-3582","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acl","category-aspetar-hospital","category-course","category-knee","category-knee-injuries","category-uncategorized","tag-acl","tag-knee"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":6}},"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t