Despite the timeline passing for DIS eligibility, the fact a repair option regrowing ACL’s has existed for so long spurred me to keep looking.
I came across article A Review of Ligament Augmentation with the InternalBrace
Halfway through the 18 pages I find some application to the ACL, how it reduces harvest site morbidity & cost.
Based on the US stat 1 – 10 per 1000 people = 100k – 400k ACL reconstruction s occur annually; Canada would have 32,000+ reconstructions, which involves removing or bypassing the remaining ACL, despite in the majority of cases sufficient tissue remains for a repair to be considered, particularly within 3 months.
It explained grafts do not produce a normal feeling knee; there’s a loss of proprioception, which when present is important as this prevents overloading of the ACL graft; and estimates less than 50% of patients return to sport, and those that do often find they cannot perform at the same level.
“Graft harvest is associated with a degree of morbidity from tissue loss; muscle weakness with hamstring grafts & anterior knee pain are common with patellar tendon grafts.”
“there is a decrease in knee power and work performed postoperatively by the muscles around the injured knee”
“compensatory mechanisms of muscle use persist in the majority of patients, indicating sub optimal performance of the reconstructed graft”
There was also a study cited confirming “significant increase in osteoarthritic changes as early as a year post op” and stats on reconstruction failures.
“The clinical benefits of a well prepared and healed ACL are likely to be greater for patients than those offered by a traditional ACL reconstruction”
“Sufficient ACL tissue can remain for up to 3 months following ACL injury to allow a repair; procedure is time dependent as the ACL remnants are not suitable for direct repair after the tissue retracts and atrophies”
Perhaps this is an option I am still within the timeline for. I have just under 5 weeks left if it is.
The Internal Brace is a 2mm high molecular weight polyethylene that protects a repair by being a check rein if the ligament is stretched beyond its physiological range. Should failure occur reconstruction remains possible without compromise to the knee joint.
Earliest patients are from Sept. 2011
If found suitable, the ability to repair a torn ACL can be confirmed at the time of #surgery.
“Early phase rehabilitation was consistently accelerated. Limited pain and selling facilitated early range of movement, muscle control and restoration of function.”
“…avoidance of donor site morbidity & minimal surgical trauma.”
“better outcomes were achieved for ACL repair at the majority of time points”
“Pain…was less in patients”
“4 cases had arthroscopically confirmed ACL healing”
“…eliminate the shortcoming of current reconstruction techniques”
“…change in orthopaedic practice relegating ligament reconstruction appropriately as a salvage procedure; only if the tissues fail to heal adequately after augmentation & repair.”
The article is from back in 2015, so I start searching the authors of the published medical journal studies and references to find other research they’ve done.