HealthWatch: Repair, Not Reconstruct Torn ACLs!

Health Watch

Washington, D.C. (Ivanhoe Newswire) — It’s a common sports injury. A torn anterior cruciate ligament-or ACL holds the knee in place. Now, some surgeons are testing a minimally invasive repair using polymers that are as durable as Kevlar: the material used in bulletproof vests.

Friends told Brian Radecki he’d never do this ever again. In April 2018, the 48-year-old was hiking in Joshua Tree National Park with his family. His foot stopped, but the rest of his leg kept moving.

Radecki said, “My ACL popped, and basically ripped right off the bone.”

Instead of conventional ACL surgery, which would have required a grafted tendon from another part of his body, Radecki wanted something better. As the founder of a biotech company, he was comfortable trying someone else’s new medical technique. Wiemi Douoguih, MD, an Orthopedic Surgeon at MedStar Orthopaedic Institute at MedStar Washington Hospital Center is among a handful of orthopedic surgeons using a new procedure to repair the torn ACL.

During a 30-minute procedure, Dr. Douoguih then creates a bracing system inside the knee.
Douoguih said, “You put stitches into the native ligament, and you pass the rope through the center of the ligament or around the ligament, and it acts like a check rain or a strut.”

Ten months after surgery, Radecki was back on the slopes, the ice, and the streets.

“I have zero restrictions,” said Radecki.

With a knee that is as good or better than new.

Dr. Douoguih says this new procedure is not for every patient who has a torn ACL. He says it seems to work best on patients who have a ligament that has a clean tear from the bone, like Radecki. Also, he says having the new procedure does not preclude patients from having conventional ACL surgery in the future, if needed.

Contributors to this news report include: Cyndy McGrath, Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.
Free weekly e-mail on Medical Breakthroughs from Ivanhoe. To sign up: http://www.ivanhoe.com/ftk

BACKGROUND: An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL), one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing, such as soccer, basketball, football and downhill skiing. Many people hear or feel a “pop” in the knee when an ACL injury occurs. People who experience an ACL injury are at higher risk of developing osteoarthritis in the knee. Arthritis may occur even if you have surgery to reconstruct the ligament. Multiple factors likely influence the risk of arthritis, such as the severity of the original injury, the presence of related injuries in the knee joint or the level of activity after treatment.
(Source: https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738)

TREATMENT: During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon, tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft. Wiemi Douoguih, MD, an Orthopedic Surgeon at MedStar Orthopaedic Institute at MedStar Washington Hospital Center said, “The traditional way or conventional way of fixing an ACL is by replacing it. So, you take a tendon from somewhere else in the body. And that tendon acts like a rope and hopefully will keep the knee stable. And in most cases, it does. It actually does a very good job of keeping the knee stable. In fact, when I finished my fellowship training back in 2003, I thought we were essentially perfect at it. You know, you’re almost brainwashed into thinking it’s perfect. But now we’re in the era of big data. And so we see that some of the earlier studies had biases.”
(Source: Wiemi Douoguih, MD & https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20350744)

NEW TECHNOLOGY: Dr. Douoguih talked about why bracing is better than replacing for some patients, “When you take out the ACL and you replace it with a dead tendon from somewhere else, you’re losing nerve fibers that act like a neural connection, like a circuit. So you’ve broken the circuit. What happens in the human brain is that it’s like a GPS system. You take a wrong turn, the map disappears. You have to pull over the side of the road and wait for it to recalibrate. And then once it recalibrates, it gives you a totally new map. Or in that setting when you’ve done ACL reconstruction, a conventional ACL reconstruction, it may take 18, 24 months to re-establish that map in your brain.”
(Source: Wiemi Douoguih, MD)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

So Young Pak, MedStar PR
202-877-2748
soyoung.pak@medstar.net

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Copyright 2020 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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