Dr Tom Cross with his late father Dr Merv Cross. Dr Tom is holding up the SecuTec Genu Knee Brace, instrumental in the Cross Brace Protocol

Dr. Tom Cross and his team at the Sydney Stadium Clinic have revealed that a novel bracing and rehabilitation protocol successfully treats specific high-grade anterior cruciate ligament (ACL) tears without surgical intervention. This therapeutic approach, now officially deemed the Cross Brace Protocol, uses bracing to manipulate the range of motion in the knee over a 6, 8 or 12-week period. During this time, incremental alterations to flexion and extension stimulate healing by enabling ruptured ACL fibres to reconnect.

What began as a research ambition has quickly evolved into a novel clinical program, as promising data continues to tip the balance towards conservative therapeutic approaches and offer a third vector for ACL injury management beyond surgery and rehabilitation alone. Since 2019, Dr. Cross and his team have worked with Bauerfeind utilising the SecuTec Genu as the brace for the protocol.

The CBP has three key pillars:

  1. A patient must be braced when full healing capacity of the ligament is present, determined to be 3-13 days following rupture.
  2. Bracing aims to facilitate complete structural healing of the torn ACL fibres.
  3. Rehabilitation alongside bracing aims to restore and preserve the functional capacity of the ligament.

The CBP begins by immobilising a patient's knee at 90 degrees for four weeks, followed by gradual adjustments to the range of motion for the subsequent weeks. A comprehensive rehabilitation program alongside the bracing regime maintains functional and neuromuscular stabilisation in the knee to enable a safer return to activity after completing the protocol.

Selecting a knee brace tailored to the demands of the CBP and comfortable enough to encourage patient compliance was a key challenge for Dr. Cross and the team. For 12 months, the CBP committee, including leading sports clinicians, underwent a rigorous brace evaluation exercise assessing the various options available. We are proud to have partnered with Dr. Cross to provide a scalable, customisable, and user-friendly ACL brace to provide patients with the necessary comfort and stability to navigate the protocol. 

 

Why is the SecuTec Genu ideal for your Cross Brace Protocol patients

1. Angle Manipulation

Our dedicated research & development team in Germany created a specialised set of limitation blocks exclusively for the CBP that enable extension limitations at 60, 75, and 90 degrees, per the CBP requirements. Combining this custom set with the standard flexion and extension limitation blocks allows the SecuTec Genu to accurately achieve the necessary range of motion restrictions for each protocol stage. The easy scalability and adaptability of the brace ensure it meets the level of precision needed under the CBP to maintain the healing process while enabling patients to progress through the protocol seamlessly.

Close up of the SecuTec's hinges, which are key in healing the acl during the Cross Brace Protocol

 2. Sizing diversity

The SecuTec Genu is available in 7 standard sizes and left and right anatomical variants. A clinician can determine their patient's ideal size through two unique circumference measurements- one at the thigh and one at the calf. This allows us to present an anatomically contoured brace that is partially customised to the shape of the patient to ensure comfort and a perfect fit.


 3. Comfort is Key

One of the greatest factors encouraging strong patient compliance is the comfort the SecuTec Genu provides. Rigid braces are often seen as cumbersome, and the notion of being strapped with a brace for weeks on end may be unnerving for patients looking to undergo the CBP. However, our SecuTec Genu frame is composed of lightweight aluminium that is shapeable to the patient's leg, reducing bulkiness and promoting tolerability throughout the protocol. The frame is supported by an adjustable strapping system, which allows you to optimise the fit to anchor the brace in place. As ACL ruptures often come with swelling, the straps are also essential to allow clinicians or the patient to adjust the brace accordingly to maintain comfort and a user-friendly experience.


4. Innovative Donning and Doffing

SecuTec donning and donning process to avoid extending the leg and re-damaging the acl

The SecuTec Genu isn't a step-in brace. The innovative buckle system enables patients to conveniently don and doff the brace by simply clipping and unclipping the buckles, allowing the knee to remain affixed at the required positions. This allowance is particularly crucial in the first 4 weeks of the CBP, where the patient’s knee must stay locked at 90° without movement. Stepping into a standard brace without the ability to simply place the brace on the knee may impact the patient's ultimate success and level of healing. 


The latest promising data

According to the first officially published study of the CBP in the British Journal of Sports Medicine, 90% of participants with a fully ruptured ACL showed evidence of ACL healing at the 3-month MRI scan, along with improved knee function, less passive knee laxity, and a higher return to sport rate. This original research drives optimism in the CBP as a viable ACL treatment avenue that is clinically effective and powered by favourable patient outcomes and higher quality of life.

 

Our commitment  

Our local and global product technicians continue to work very closely with The Stadium Clinic and private practitioners nationwide. We aim to assist in carrying out the Cross Brace Protocol for clinics looking to participate through workshops and training programs. Our efforts are powered by our launch of the CBP Service and Support Program, through which we partner with clinicians to provide patient support and host CBP educational workshops to guide practitioners in fitting and tailoring the SecuTec Genu for their patients. Leaning on our direct participation and learnings with the protocol's creators, we aim to provide patients and clinicians with our understanding and expertise of best practices.  


Bauerfeind presenting to clinicians who want to participate in the Cross Brace Protocol for non-surgical ACL treatment

 

For your ACL 

If you’d like to learn more about the CBP please reach out directly to the official Heal ACL team for any clinical queries for your patients. For more information on the SecuTec Genu product contact Bauerfeind's support team at business@bauerfeind.com.au or call 1300 668 466.

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