Unfortunately, ACL injuries aren’t going away any time soon.
Although strength coaches and athletic trainers take greater preventative measures than ever before to protect the anterior cruciate ligament, only so much can be done. An estimated 150,000 ACL tears still occur every year in the United States. Athletes suffer most of them, and it’s not uncommon for an athlete to tear an ACL more than once during a playing career. Thomas Davis, a Pro Bowl linebacker for the Carolina Panthers, tore the same ACL three times in three years.
ACL injuries often occur as a result of the tibia and femur twisting in opposite directions under full body weight.
Certain athletes can bounce back quickly after ACL injuries (Adrian Peterson comes to mind), but others aren’t so lucky. The ACL re-tear rate is estimated to be upwards of 20 percent for teenagers; and roughly 80 percent of all reconstruction patients develop arthritis in the years following the procedure. Part of what makes recovery from a torn ACL so tricky is that the ligament does not naturally regrow itself.
“Unlike other ligaments, when the ACL tears, its ends don’t reconnect because the synovial fluid that surrounds the ACL inhibits healing,” according to the Boston Children’s Hospital on their blog. Conventional treatment for an ACL tear involves removing the torn ends of the ligament and then constructing a totally new ACL from a tendon graft, which is usually taken from the hamstring or patella. This means patients essentially have to recover from two separate injuries—the torn ligament itself plus the area where the graft was taken.
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However, a revolutionary new surgical technique could go a long way toward making recovery from ACL tears more efficient and ultimately allow athletes to come back stronger. The bridge-enhanced ACL repair (BEAR) could change the way we think about ACL injuries. Whereas a traditional reconstructions involves taking a graft from another part of the body and constructing an entirely new ACL, BEAR allows patients to re-grow their own ACL. The idea is that the regrown ACL will result in both quicker recovery and fewer long-term complications than traditional ACL reconstruction. Watch the video:
The new BEAR procedure was pioneered by Dr. Martha Murray of Boston Children’s Hospital. The key to the new procedure is a sponge-like material crafted from the same proteins found in ligaments. Developed by Murray and her team, this material is used to connect the two torn ends of the ACL. To perform the procedure, the sponge is inserted into the area where the torn ACL once was, soaked in the patient’s own blood and then attached to both torn ends of the damaged ACL. Over time, the sponge acts as a “bridge” and allows the ACL to reattach itself, thus re-growing a fully intact ligament.
Murray and her team began performing the BEAR on human patients roughly a year ago, and the early results have been encouraging. Thus far, ten adult patients have undergone the procedure, and there have been no complications to speak of.
Corey Peak, a 26-year-old grad student at the Harvard T.H. Chan School of Public Health, was the first patient to undergo the procedure last February. Peak tore his ACL on a skiing trip. After being informed that Boston Children’s Hospital was seeking volunteers to try out a new procedure. and learning what BEAR entailed, Peak concluded that it was a better option to treat a torn ACL. Within three months post-surgery, he was jogging on a treadmill. Soon after, he was cycling to work. He has now returned to cross-country skiing, and he often forgets he suffered a torn ACL. “I’m not really even thinking about [my knee],” Peak recently told The Wall Street Journal. “It’s sort of like when you get over a break-up.”
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Now that small trials have proven the procedure can be effective, the next step will be a 100-patient, double-blind trial where half the patients undergo traditional ACL reconstruction and the other half undergo BEAR. All patients will receive identical post-operation therapy. If the BEAR proves to be a superior option, it could become the new standard procedure for repairing a torn ACL.