08/06/2026
ACL Cross Bracing Protocol (CBP), about.
Give praise on bended knee for new treatment
The Sydney Morning Herald, Tuesday, June 9, 2026, p29.
Synopsis:
Each year, millions of people around the world tear or sprain their anterior cruciate ligament (ACL).
By bending the knee to 90 degrees and immobilising it in a brace, it was suggested you could bring the torn ends of the ACL closer together allowing them to heal similarly to a bone fracture.
More than 1450 patients later and a 90 per cent success rate, the cross bracing protocol ( CBP) as it came to be known, is becoming a "revolutionary'' new approach to treating ACL tears.
"ACLs are injured on a spectrum, some may have less injured ruptured ACLs and some are profoundly injured."
Some of them will heal on their own without a brace, some need a helping hand of bending the knee and putting the tissue back together, and then some absolutely need a surgeon.
Tom Cross’ expert opinion is that up to 40 per cent of people with ACL injuries could be good candidates for CBP, depending on their MRI and an assessment.
"The start of the protocol is definitely tough," a patient says. "You're not very mobile with your leg bent at 90 [degrees] all the time, but l got around on crutches or a wheelchair."
Three months later, scans showed her ACL had reattached, and her leg felt stable to move on. By the nine month mark, alongside physio rehab, she had passed her return to exercise tests. Within 14 months, she was back playing premier division AFL and made it into the Sydney Swans reserve program.
Dr Marc-Olivier Dube, an adjunct senior research fellow at La Trobe University, says it is a "promising intervention".
Avoiding surgery removes the risk of adverse events like infection, blood clots, graft-site pain and numbness. It is also significantly more cost-effective.
A new review article, co-written by Dube, notes that about half of everyone who ruptures their ACL develops osteoarthritis within 10 years, regardless of the treatment option. But, notes that up to 50 per cent may avoid surgery altogether through progressive rehabilitation alone while having similar outcomes to those who have had surgery.
For full article see newspaper article mentioned above.
