A New Old Approach
Exploring the Cross Bracing Protocol: A New Option for ACL Injury Management
If you’ve recently suffered an ACL injury, you may be wondering about your treatment options. Traditionally, ACL ruptures have often been treated surgically, but emerging research offers a promising alternative: the Cross Bracing Protocol (CBP).
What is the Cross Bracing Protocol?
The Cross Bracing Protocol was first implemented by Dr. Tom Cross’ father, Mervin. This innovative non-surgical management strategy for acute ACL ruptures immobilizes the knee at 90 degrees of flexion for four weeks to facilitate natural healing. After this period, knee range-of-motion is gradually increased while engaging in a supervised rehabilitation program. Dr. Tom Cross and Stephanie Filbay have since provided seminal, emerging evidence of the protocol’s healing capacity through robust research. The CBP aims to reduce the gap between the ruptured ACL ends, promoting tissue bridging and healing.
Promising Results
A study conducted on 80 patients using the CBP showed remarkable results:
- Healing Evidence: At the three-month follow-up, 90% of participants displayed MRI evidence of ACL healing. Specifically, 50% had a continuous thickened ACL, while 40% showed a continuous but thinned or elongated ACL.
- Patient Outcomes: Those with more healing reported better knee function, higher quality of life, and a higher return-to-sport rate.
- Re-injury Rates: Only 14% of participants experienced re-injury, primarily in high-energy sports.
The Role of Surgery
While the CBP shows great promise, it’s important to acknowledge that surgical intervention remains a crucial option for many patients. The success of the CBP heavily depends on specific conditions observed in MRI scans:
- Gap Between Ruptured Ends: Minimal gaps increase the likelihood of successful healing.
- Intact Synovial Envelope: An intact synovial envelope around the ACL promotes better healing.
- Intact Femoral Origin: If the femoral origin of the ACL remains intact, the chances of successful non-surgical management are higher.
When these conditions are not met, the likelihood of successful outcomes with the CBP diminishes. This underscores the importance of having an experienced professional assess your MRI scans and develop a collaborative treatment approach tailored to your specific needs.
Seeking Professional Guidance
Deciding on the best treatment for an ACL injury can be challenging. It’s essential to work with a knowledgeable and experienced physiotherapist who can evaluate your condition and guide you through the appropriate management options. At PPI, our team is equipped to provide comprehensive assessments and develop individualized treatment plans, whether through the CBP or surgical intervention.
If you have an ACL injury and want to explore your treatment options, contact PPI today for expert assistance. Together, we can determine the best path to recovery and help you get back to your active lifestyle.
