Alan
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- Oct 22, 2013
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If this is true, then why are you more likely to re-injure the same ACL/MCL? I believe you're wrong about this. 97.4% sure.LACHAMP46 with this strange tidbit:
I've read the repair is stronger than the original ACL....I was actually surprised he re-tore the same one....
Here's some stuff that might help:
Q: Is the ACL the most fragile knee ligament, or do sports fans just hear about those injuries more often?
http://sciencelife.uchospitals.edu/2012/05/01/qa-dr-martin-leland-on-acl-injuries/
The most commonly injured ligament in the knee is the MCL. But the MCL when injured in isolation, it heals very well non-operatively. So some people will be in a knee brace for six weeks and then get right back out there. Professional football, if it’s a mild injury, they might not even miss a game. People are injuring their MCLs all the time but we never hear about them, because it’s not nine months until you come back, it’s anywhere between two and six weeks.
Q: When the ACL is torn, is the treatment always surgical?
Assuming the ACL is completely ruptured, generally speaking with a cutting and pivoting athlete, especially a high level athlete, the treatment is always surgical. In patients that have a partial ACL tear where the cell fibers have been stretched but not completely torn and it’s just a little bit loose, they can usually be treated with rehab and then getting them back to sports. But if the fibers are completely torn, you usually recommend reconstruction because you can’t repair the ACL. If you try to put stitches in the ACL, they’ll just pull right through. You’ve got to actually pull that torn tissue out and put other tissue in its place, either from the patient’s patellar tendon or from their hamstrings. Occasionally, people will use a quadriceps tendon or tissue from someone who died, which is called an allograft or cadaveric tissue.
The reason why we recommend surgery is because 90-plus percent of people who have an ACL tear will continue to have instability, and if they try to get back into sports without having reconstruction, it’ll pivot out of place again. Every time the knee pivots out of place, you risk doing damage to the cartilage or the meniscus, and sometimes you can actually do damage that can’t be repaired. If you allowed Rose to continue playing, he probably wouldn’t be able to play, because every time he’d pivot on his knee, his knee would buckle, it would swell up, and he’d be done for the game. Then it will buckle again as soon as he went back on the court, and he might do more permanent damage that can’t be repaired and could lead up to shortening his playing days.
Q: What are the chances of re-injuring the knee after an ACL reconstruction? Will Derrick Rose ever be the same player again?
The treatment has changed a lot, it’s constantly changing. The way in which we do ACL reconstructions is very different, especially with where we put the ACL, from what we did even five years ago. However, it’s been a very successful surgery for quite some time. We frequently will tell patients that 90 to 95 percent of people will get back to complete activity with no problems from where they were pre-operatively. But what we’re finding now from the long-term literature is that with procedures from 10 to 20 years ago, maybe only 50 percent of people truly got back to that elite level of activity. But techniques are constantly changing, it’s been a very successful surgery for quite some time. I would even venture to say that when we look back 15 years from now, we’ll have even better results than what we had 10 years ago.
http://spectrumhealthblogs.org/you-me-and-pt/2014/02/13/dreaded-injury-olympic-athlete/
Lindsey’s re-injury to her reconstructed knee after many months of grueling rehabilitation is a perfect example of how devastating these injuries can be. It has been found that the risk of a second injury to the ACLR within the first 12 months is 15 times greater that an uninjured athlete. According to the research presented at the 2013 annual meeting of the American Orthopaedic Society for Sports Medicine, the risk of ACL injury is six times greater in the same or opposite knee for those who have already suffered an ACL reconstruction. In addition to this, a systematic review from 2011 reported that following ACLR the rate of tearing the opposite side ACL (11.8% injury rate) is double the risk of re-tearing the ACL graft (5.8% re-injury rate). That means that some studies suggest one in ten athletes are at risk of tearing the opposite side ACL following surgery – this is so eye opening!
More shockingly, a recent article published in the American Journal of Sports Medicine reported that patients younger that 20 years who undergo ACLR are at significant risk for graft re-injury or opposite leg ACL injury. They found that “1 in every 3.5 patients who underwent ACL Rand were younger than 20 years sustained a further ACL injury to either knee within a 5-year period.” These statistics are alarming!
ACL re-injury is affected by so many factors including surgeon experience, graft placement, graft type, gravest harvest site, age, physiological factors, rehabilitation and fear avoidance. I believe that more research also needs to be dedicated to look at ACL prevention programs. If we can lower the rate of injury, we will lower the rate of re-injury. Stay tuned over the next couple months for advice on joint protection and ACL prevention exercise.
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