Joint Preservation Blog

January 22, 2009

ACL Laxity and Knee Braces

acl laxity and knee braces

A doctor discusses ACL Laxity and Knee Braces. The ACL is the duct tape in the knee that holds the big thigh bone (femur) to the leg bone (tibia). It stabilizes (along with the PCL) the knee in a front-back direction. A knee brace can be used to help the ACL. An ACL knee brace allows the knee to flex and extend while holding the thigh and leg bones in alignment. However,is there a better way than wearing a knee brace all the time? Knee surgeries to replace or reconstruct the ACL should only be performed (in my opinion) if the ACL is completely gone. if the ACL is just lax, an older method of treatment is prolotherapy. This is the injection of a substance to tighten the ligament. Reeves has shown that the ligament can be tightened in this way using monthly shots for about 6 months. Newer options already being performed in the US include seeding the patient’s own adult stem cells onto the ACL ligament to repair the damage. This only works if there are ACL fibers left to seed. Eventually, this same technique may be used to inject an ACL scaffold material into the knee with adult stem cells that can create a ligament. So if you have a stretched ACL and you’re using a knee brace for ACL laxity, investigate some of the injections that can help you loose the brace!

December 23, 2008

ACL Laxity and Knee Braces

ACL Laxity and Knee Braces.  The ACL is the inner duct tape (otherwise known as a ligament) that holds the knee together in a front-back direction.  This means that it prevents the lower shin bone (tibia) from moving forward on the thigh bone (femur). This ligament can be stretched or torn completely.  In these cases the joint is said to be “lax” and in need of either surgical repair, non-surgical repair, or knee bracing.  Bracing a knee with ACL Laxity involves stabilizing the femur and tibia in a front-back direction. However, there are pros and cons.   One of the problems is that bracing still allows some movement, which ultimately injuries the joint.  Up until now, there has been no way to repair a stretch injury to the ACL without surgery. However, the development of injection based therapy for partial ACL tears and laxity has been a big advancement beyond surgical grafts.  As an example, the Regenexx procedurenow allows doctors to inject the patient’s own stem cells onto the stretched ACL ligament and tighten that ligament back to it’s normal strength and length.  This development allows the patient to get rid of the brace all together.  Since there is no surgery needed, the recovery is much quicker and bracing is only used for a few weeks after the procedure if the laxity is severe.  This newer technique doesn’t work when there is no ACL left, but only if there are ACL fibers that can still be detected on MRI.  

As a physician who treats patients with these injuries, the best brace is the one that fits well.  For general fitting and measuring instructions, click here. Also, I often advise my patients to consider getting a slightly used brace.  Ebay can be a great place to to find a knee brace that will help with ACL laxity.

Below is a short video on the topic of repairing ligament tears by injecting your own stem cells.  While this shows an ankle ligament example, this could just as easily be a partial ACL tear.

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