Knee Brace Recommendations for Grade 2 MCL Tear
For a grade 2 MCL tear, a functional knee brace with hinges that limits valgus stress while allowing controlled range of motion (30-90 degrees) is recommended for optimal healing and protection. 1
Brace Type Selection
- A functional knee brace with either unilateral or bilateral hinged bars should be used to provide support for mild to moderate MCL instability 2
- The brace should be the longest length that comfortably fits the patient's leg, as shorter braces provide less MCL protection 2
- Braces with a "hinge-post-shell" or "hinge-post-strap" design are most appropriate for MCL injuries 2
Specific Range of Motion Settings
- A restricted range of motion setting (30-90 degrees) has shown better outcomes than a fully protected setting (0-90 degrees) for moderate-to-severe MCL injuries 1
- This restricted setting tends to provide:
- Better patient adherence
- Higher satisfaction
- Improved function
- Better overall knee scores and quality of life 1
Duration of Bracing
- Constant brace wearing for the first 4 weeks
- Daytime wear until 6 weeks post-injury
- Rehabilitation exercises should begin from 2 weeks onward 1
Brace Fitting Considerations
- Proper application is essential for brace efficacy:
- Regular tightening of straps, tape, or hook-and-pile fasteners helps reduce unwanted migration
- Shaving leg hair and fitting the brace closely to leg contours improves contact and limits slippage
- Correct placement of hinges relative to femoral condyles is essential for optimal performance 2
Custom vs. Off-the-Shelf Braces
- Off-the-shelf braces are generally sufficient for most MCL injuries 2, 3
- Research shows no significant advantage of more expensive custom-fit knee braces over off-the-shelf options for stability, muscle strength, endurance, or response times 3
- Off-the-shelf braces may actually have less migration during exercise compared to custom braces 3
- Presized braces may be better when cost or rapid availability is important 2
Important Caveats and Limitations
- Brace effectiveness is limited at physiologic stress levels - subjective benefits often exceed objective findings 2
- A brace alone cannot fully restore normal MCL function under valgus stress 4
- Bracing should be combined with appropriate rehabilitation exercises for optimal outcomes 2
- Strength training, conditioning, technique refinement, and flexibility are more important than bracing alone in MCL injury management 2
- Regular assessment of brace positioning and structural integrity is necessary; damaged braces should be replaced 2