Repairing the ACL within a few weeks or months of injury has become the standard of care. However, is this really best for the patient? A new study demonstrates that we may be harming more patients with this approach than we’re helping. Let’s review.
ACL ReconstructionI have seen many surgeons conclude that ACL reconstruction is one of the most successful orthopedic surgeries ever devised. Having said that, the actual high-level research on the procedure is not all that impressive. For example,. In addition, patients often decide to get. However, research has shown that the procedure doesn’t reduce the rate of arthritis, meaning that those who get the procedure have just as much arthritis as those who don’t. In addition, The KANON TrialYou would think that given the popularity of the procedure, we would have lots of high-level research showing that ACL surgery works.
We really don’t. One of the few randomized controlled trials out there, which was performed at Lund University in Sweden, is called the KANON trial, which stands for Knee Anterior cruciate ligament NONoperative versus operative treatment. The authors of that study relay that prior to their research, there were only two high-level studies performed on ACL surgery (Sandberg et al in 1987 and Anderson et al in 1989). The New Research on ACL Surgery and Cartilage Lossand was a reanalysis of the five-year data from the previously published KANON trial, which itself didn’t find that ACL surgery was the bomb. The striking finding of the new research was that the patients who were randomized to get early ACL surgery had more cartilage loss in their knee at five years post surgery than those who were randomized to get physical therapy and later decide if they still needed surgery. How much more?
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Anterior Cruciate Ligament Reconstruction (ACL) surgery is a common intervention. 1 in every 3,000 American suffers from a ruptured ACL and between 100,000 and 300,000 reconstruction surgeries will be performed each year in the United States.
About twice as much cartilage loss! Why Is This Happening?First, this is the first high-level study to look at ACL surgery and cartilage loss in a randomized fashion where half of the patients were assigned to an early surgery+rehab group and half to a delay surgery+rehab group.
Second, you also need to realize that, 98% of the patients in the early surgery+rehab group had surgery compared to only 39% in the delay surgery+rehab group. Meaning, what this cartilage comparison is measuring is the negative effects of the ACL surgery.Hence, if this finding holds up across multiple studies, why would this be the case? First, realize that an ACL reconstruction surgery doesn’t replace the original equipment, so what you end up with is, at best, an imperfect substitute for what you had. See my video below for a better explanation. Meaning, the tendon graft that replaces the ACL has the following biomechanical problems when compared to having a torn ACL:. It goes in at a much steeper angle than the original ACL, reducing the ability of the reconstructed ligament to stabilize the knee in various positions.
SpineMany spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density. Herniated, Bulging, Protruding Discs. Degenerative Disc Disease. SI Joint Syndrome.
Sciatica. Pinched Nerves and General Back Pain. And more. KneesKnees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective.
Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis. Knee Meniscus Tears.
Knee ACL Tears. Knee Instability. Knee Osteoarthritis. Other Knee Ligaments / Tendons & Overuse Injuries. And more. SpineMany spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery.
And epidural steroid injections are problematic due to their long-term negative impact on bone density. Herniated, Bulging, Protruding Discs. Degenerative Disc Disease. SI Joint Syndrome. Sciatica.
Pinched Nerves and General Back Pain. And more. HipHip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time.
Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures. Labral Tear. Hip Arthritis. Hip Bursitis. Hip Sprain, Tendonitis or Inflammation.
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Hip Instability. DISCLAIMER: The procedures and claims made about particular procedures on or through this site have not been evaluated or approved by the FDA. All statements, opinions and references provided by GetRegenerative.com are for informational purposes only. They do not constitute an endorsement of any medical provider nor guarantee the efficacy of the treatments provided. Get Regenerative does not diagnose or treat medical conditions via this website or via telephone. This site disclaims any liability for damages or negative consequences from treatments provided by the physicians listed herein to any person referencing GetRegenerative.com.