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Exciting Early Results: ACL Scaffold Repair

Our current best ways to treat a torn ACL is a surgical procedure called a “reconstruction”, where a substitute tissue (a “graft”) is used to replace the torn ACL. Tunnels or sockets are drilled in the bone, so the bone essentially grows into the new tissue and makes a new ACL. 

ACL surgery has improved substantially over the last 30 years, with generally excellent results. But there can be issues related to the bone tunnels potentially causing growth disturbance in young athletes, and issues related to the removal of the graft. A new type of ACL repair using stitches and a biologic scaffold to enhance healing is showing very exciting early results. If this ACL repair technique proves itself in larger clinical studies, we can expect it to be an excellent option to avoid tunnels and grafts for some ACL tear types.

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Are You Ready For Sports After Your ACL Surgery?

Does your brain think you’re ready to return to sports after your ACL surgery?

Readiness for return to sports activity after ACL surgery depends on many factors. We like to see evidence from our physical exam that the graft is properly healed, motion is back to normal, and strength is nearly normal. My partners at Stanford and I also place a lot of emphasis on normalized landing mechanics and other movement-based measurements. And another area we like to consider is whether the athlete herself/himself feels ready to return to sports. It turns out the psychological readiness is a bigger factor than we’ve realized.

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ACL Reconstruction Is Getting Better All The Time

In today’s blog post I’d like to take a look at improved outcomes over the last 25 years from a commonly performed orthopedic sports medicine surgery: ACL reconstruction. We’ve come a long way over this time, with improvements in patient reported outcomes as well as improvements in measured stability of the knee.

Orthopedic surgeons use various objective criteria to assess the stability of the knee. In 1994 when I started my orthopedic practice I typically quoted an 80% success rate in terms of restoring excellent stability to the knee after ACL reconstruction surgery. Today, that number is about 95%.

How the patient who’s had surgery feels about his or her own knee has also improved quite a bit over this time. It’s difficult to find published patient reported outcomes from the early 90s but it’s fair to say that a large percentage of patients weren’t entirely happy with their knees after surgery. Perhaps 40% of people reported difficulties with their knees. Nowadays patient reported outcomes are generally very favorable for about 80% of knees at least two years after surgery.

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