New Approach to ACL Repair
Reported January 2011
ATLANTA, GA (Ivanhoe Newswire) -- From professional athletes to weekend warriors, doctors see more than 95-thousand ACL injuries every year. If it’s injured or torn, surgery may be needed to repair it, but studies show as many as 30 percent of ACL repairs fail, keeping athletes from getting back to their pre-injury levels. Now, one doctor thinks he has the answer to get these players back in the game.
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When 28-year-old Lisa Kilpela tore her ACL three years ago, she thought surgery would be a permanent fix. Then, her knee problems came back.
"It felt really unstable, when I'd step on it, my knee would slip a little bit,” Kilpela told Ivanhoe. “I would straighten it out and it would get stuck or I would bend it and I would have trouble straightening it back out.”
"You can have what appears to be a perfectly done ACL that has healed and has undergone perfectly good rehab and yet fails to control the knee, fails to provide stability to the knee," Spero Karas, M.D., an orthopedic surgeon at Emory Sports Medicine.
Doctor Karas says traditional ACL repair can restore front to back stability, but that may not be enough.
"A upright or vertical graft allows rotation of the knee which is the more typical reason ACL's fail," Dr. Karas said.
Dr. Karas is pioneering a significant change to ACL surgery instead of the traditional approach, creating one vertical ACL tunnel on the tibia and the femur; he now creates two tunnels on each bone.
“You can put the tibial tunnel in a perfect position and you can put the femoral tunnel in a perfect position which puts the entire graft in a perfect position,” Dr. Karas said.
Biomechanical studies show this repair means more stability, and less chance of failure.
“By bringing the graft through an independent femoral tunnel low on the wall, now you can control not only anterior to posterior translation but you also control the rotational stability of the knee,” Dr. Karas
“I think I'm still a little hesitant to all out really plant on it, but otherwise it feels pretty good,” Kilpela said.
One year after surgery, Lisa's hitting the court with more confidence and it's an active young woman who’s definitely back on her game. Dr. Karas and other surgeons at Emory Sports Medicine believe this new technique will mean more anatomical ACL repairs, with better long-term success.
Click here to Go Inside This Science or contact:
Spero Karas, MD
Emory Sports Medicine
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