Bracing the anterior cruciate ligament deficient knee using the Lenox Hill derotation brace.

The Lenox Hill derotation brace fashioned by Castiglia and his staff at the Lenox Hill Hospital Brace Shop (New York, New York) under the direction of Nicholas during the 1960s has been worn successfully by thousands of patients with unstable knees, including elderly arthritic patients, adolescents with congenital instability, and professional athletes. Nearly 9000 braces were worn by patients in the United States during the period from 1976 to 1980. The brace, with its sliding axis of motion, corresponds to the axis of movement in the knee. The combination Lenox Hill brace includes not only the sliding axis of motion, but also a second below-knee leg pad, second derotation strap, and hyper-extension stop. It is designed to resist the combination anteromedial-rotatory, anterolateral-rotatory, and anteromediolateral-rotatory instabilities. More than 70% of the braces prescribed during the last five years have been the combination type. The derotation brace is a significant advance in brace designs for supporting chronic unstable and surgically reconstructed knees. It can function effectively even when the wearer is actively participating in sports.