The Cross Bracing Protocol (CBP) was recently featured in Men’s Health Magazine’s Must Read section, meaning this innovative procedure for Anterior Cruciate Ligament (ACL) repair is quickly gaining traction.
ACL tears are among the most common injuries in sports, and the incidence rate is only increasing. While reconstruction surgeries offer great results (especially among active populations), many patients want non-surgical alternatives.
The CBP offers an 8-12-week bracing and rehabilitation plan. Despite prior assumptions that surgery was the only option for ACL ruptures, initial results are highly promising.
In summary:
- The CBP is a bracing and rehabilitation method developed by Drs. Merv and Tom Cross to heal complete ACL tears and ruptures.
- Previously, surgery was thought to be the only way to repair this ligament, so it offers an alternative treatment vector.
- The patient’s knee is braced at 90 degrees for 4 weeks with gradual ROM increases over the next few weeks.
- The CBP has been tried and tested on over 1000 patients, with the initial study reporting 90% of participants showing signs of ACL healing at the 3-month MRI.
- Our very own SecuTec Genu Knee Brace with specialised CBP limitation blocks is the preferred brace for this treatment.
Men’s Health details the story of how the CBP came about, from the series of coincidences that led to the very first CBP trial on a Netball player through to clinical trials and adjustments.
It all started when a 19-year-old patient visiting Dr Tom’s clinic said she would do anything to avoid ACL surgery. Overhearing this, Dr Merv, who was mulling over non-surgical treatments for this injury at the time, got an idea. There had been documented cases where the ACL ends reattached naturally, and an older method of 90-degree casting, but no formalised process existed yet.
Given that the netball player was the child of one of the clinic’s staff and had been a long-time patient, it was an opportunity to trial a new vector in ACL repair.
After assurances that she could go on to have surgery if the treatment didn’t show good results, she agreed, and the first CBP trial was on the way.
To quote the article:
Twelve weeks later, they had an answer. “I’ll never forget examining her knee,” says Dr Cross. She’d had no ACL endpoint. “And then, there was one. And the MRI showed that it healed.” Nature had done the work for them.
Bauerfeind’s Role in Non-Surgical ACL Treatment:
In 2019, Dr Tom formed his CBP team and partnered with Bauerfeind ANZ to create the brace of choice for the CBP. Their specifications included:
- Comfort to ensure compliance, including a lightweight design and padding that would minimise the risk of irritation, bruising, and sores
- Lockable hinges at 90 degrees with gradual 5-10 degree limitation blocks as the CBP progressed
- And a donning process that does not require the patient to extend their knee past 90 degrees, especially during those first few crucial weeks.
Our already existing SecuTec Genu was almost perfect for the job, so our technicians got to work on the finishing touch: CBP-specific limitation blocks.
These blocks let you restrict your patient’s ROM to angles of 60°, 75°, and 90° alongside the SecuTec’s original 0°-90° flexion and 0°-40° extension ranges as the ACL heals.
Learn more about our involvement and future directions: Partner with Bauerfeind for the Cross Bracing Protocol
Important Notes on ACL Healing Capacity
The CBP with Bauerfeind’s SecuTec offers a great option for patients wanting to avoid ACL reconstruction.
However, per Dr Tom’s findings in clinical trials, not every ACL is CBP-ready. He and his team are refining diagnostic processes and assessing how patient lifestyles, physical activities, and medical histories may impact recovery and which participants may benefit more from surgery.
The CBP itself is still in the clinical trial stage, and although it’s demonstrating fantastic results, some patients may require even more tailored bracing plans that build on CBP principles.
To quote Men’s Health:
One of Dr Cross’s key takeaways from this work so far: Every ACL injury is unique—and treatment should be too. In the future, he’d like to see an ACL registry that helps health pros customise a bracing protocol for each patient. For now, though, CBP is gaining traction as a viable, and far more economical, alternative to surgery for a sizable percentage of ACL injuries. But not all of them.
Dr Cross is clear that “there’s still going to be a great need for surgery. We’re all working towards the well-being of the patient. We should be delivering a balanced approach that’s accurate, scientific, and gives the patient a lot of control.”
Ready to Get Started?
Our team is ready to answer any questions you may have about the CBP and the SecuTec Genu. If you’d like to offer this novel treatment method to your patients, get in touch with us. If you’re not a partner yet, it’s easy to sign up in our partner portal.
We offer training sessions, brace fittings, and ongoing support to all partnering clinics (as well as rewards!)
