A systematic review of prophylactic braces in the prevention of knee ligament injuries in collegiate football players

Abstract

Objective: To determine the relative risk reduction associated with prophylactic knee braces in the prevention of knee injuries in collegiate football players.

Data sources: An exhaustive search for original research was performed using the PubMed, SportDiscus, and CINAHL databases from 1970 through November 2006, with the search terms knee brace, knee braces, knee bracing and football, prophylactic brace, and prophylactic knee braces.

Study selection: Seven studies comparing knee injuries among braced and non-braced collegiate football players were included. Study methods were assessed using the Physiotherapy Evidence Database (PEDro) scale. PEDro scores ranged from 2 to 5.

Data extraction: The number of participants and frequency of knee injuries were used to calculate the relative risk reduction or increase.

Data synthesis: We found a relative risk reduction for 3 studies with point estimates of 10% (36% to -26%), 58% (25% to 76%), and 56% (13% to 77%). Four studies demonstrated an increased risk of injury, with point estimates of 17% (19% to -71%), 49% (-31% to -69%), 114% (23% to -492%), and 42% (-18% to -70%).

Conclusions: Data from existing research are inconsistent. Based on a Strength of Recommendation Taxonomy level of evidence of 2 with a grade B recommendation, we cannot conclusively advocate or discourage the use of prophylactic knee braces in the prevention of knee injuries in collegiate football players.

Keywords: injury prevention; protective equipment.

Figure 1. Numbers needed to treat to benefit or numbers needed to treat to harm for the 7 studies: Hewson et al, Teitz et al, Rovere et al, Albright et al, Sitler et al, Zemper, and Hansen et al.

Figure 2. Relative risk increase or relative risk reduction demonstrated by the 7 studies: Hewson et al, Teitz et al, Rovere et al, Albright et al, Sitler et al, Zemper, and Hansen et al.