Exploring and comparing bracing protocols for acute isolated posterior cruciate ligament injuries: A scoping review of rationales and approaches

Background

Posterior cruciate ligament (PCL) injuries often result in persistent knee laxity and functional deficits, highlighting the importance of treatment. Dynamic bracing is widely employed in non-operative management, yet standardised protocols remain undefined.

Aim

This scoping review maps existing literature on dynamic bracing for acute isolated PCL injuries and identifies evidence gaps to guide future research.

Methods

A systematic search of PubMed, Embase, CINAHL, and SportDiscus identified relevant studies published up to July 2024. The Population, Concept, and Context framework guided study selection. Eligible studies included articles reporting on non-operative management of acute PCL injuries using dynamic bracing protocols initiated within 12 weeks of injury.

Results

Of 1810 screened studies, 13 met inclusion criteria: seven primary research studies and six reviews. Bracing protocols varied significantly in type, duration, knee flexion angles, weight-bearing status, and activity restrictions. No studies compared different dynamic bracing protocols or directly evaluated their efficacy. Most studies lacked a clear rationale for protocol design, with only four citing prior studies. No recommendation can be made on a bracing protocol.

Conclusion

Evidence on dynamic bracing for acute PCL injuries is limited and inconsistent. Comparative studies are needed to establish standardised protocols and optimize non-operative PCL management.