Key Points
- Effective Healing: The Cross Bracing Protocol (CBP) demonstrated a high success rate in ACL healing as visualised on MRI.
- Improved Outcomes: Patients managed with CBP reported better knee function, quality of life, and higher return-to-sport rates compared to other methods.
- Non-Surgical Alternative: CBP offers a viable non-surgical treatment option for ACL ruptures, reducing the need for surgical intervention.
ACL injuries and their treatment options
What is an ACL injury?
The Anterior Cruciate Ligament (ACL) is a crucial ligament in the knee that helps maintain stability. ACL injuries often occur during activities involving sudden stops, jumps, or changes in direction, common in sports like soccer, basketball, and skiing. Symptoms typically include a loud “pop” sound at the time of injury, severe pain, rapid swelling, and instability in the knee.
Current treatment options for ACL injuries
There are several treatment options for ACL injuries, including:
- Surgical Reconstruction: This involves replacing the torn ACL with a tissue graft, often recommended for athletes or individuals with a high level of physical activity.
- Non-Surgical Management: Includes bracing and physiotherapy focused on improving knee stability, strength and function without surgery.
What is the Cross Bracing Protocol?
The Cross Bracing Protocol (CBP) is a novel non-surgical treatment for ACL ruptures. It involves immobilising the knee at a 90-degree flexion angle for the initial four weeks post-injury, followed by gradual increases in the range of motion over the next several weeks. This method aims to reduce the gap between the torn ACL ends, promoting natural healing and tissue bridging.
Key Components of CBP:
- Initial Immobilisation: Knee immobilisation at 90° flexion for 4 weeks.
- Progressive Motion: Gradual increase in knee movement from week 5 to week 12.
- Rehabilitation: Physiotherapist-supervised exercises focusing on muscle strengthening, neuromuscular control, and functional training.
Who will benefit from the Cross Bracing Protocol?
The CBP is particularly beneficial for:
- Individuals with acute ACL ruptures diagnosed within 4 weeks of injury.
- Patients without severe concomitant injuries that necessitate surgical intervention.
- Those capable of managing the knee immobilisation period and adhering to the rehabilitation program.
What does the research say about the Cross-Brace Protocol?
The study found that:
- High Healing Rate: 90% of patients showed signs of ACL healing on MRI after 3 months of CBP.
- Better Outcomes: Patients with continuous ACL healing reported significantly better knee function, quality of life, and higher return-to-sport rates compared to those with incomplete healing.
- Better Knee Function: Higher scores on knee function and quality of life assessments.
- Return to Sports: 92% of patients with complete ACL healing returned to their pre-injury sport.
- Re-Injury Rates: Only 14% of patients experienced re-injury, with most occurring during high-risk activities.
What are the benefits of the Cross Bracing Protocol for patients
Patients managed with CBP can expect:
- Non-Surgical Recovery: Avoiding the risks and recovery time associated with surgical procedures.
- Improved Knee Function: Higher likelihood of regaining full knee stability and function.
- Quality of Life: Enhanced overall quality of life and ability to return to sports and recreational activities.
Why consider the Cross Bracing Protocol over other treatments?
The CBP offers several advantages:
- Non-Invasive: It eliminates the need for surgery and its associated risks.
- Encourages Natural Healing: Promotes the body’s natural healing process.
- Cost-Effective: Reduces medical costs related to surgical procedures and post-operative care.
- Positive Outcomes: Demonstrated high rates of ACL healing and improved patient-reported outcomes.
You have torn your ACL but have been offered surgery? Have you considered an alternative to surgery for the management of your ACL injury? Contact us today to allow our Physiotherapist partner you in your recovery!
