Can you injure the other knee during ACL surgery recovery? There was an interesting study presented at the American Academy of Orthopedic Sports Medicine last week that got little press. A physical therapist and colleagues studied the incidence rate of a second ACL injury in the 2 years following ACL reconstruction surgery and return to sports in a young, active population. They looked at both re-tear of the graft and whether the non-operated side had an injury during recovery. In their prospective study, the researchers enrolled 78 young patients (59 women, 19 men, aged 10 years to 25 years) who underwent ACL surgery and returned to a sport and compared them to 47 healthy, control athletes without a history of ACL problems. Each athlete was followed for injury and data was collected on the time spent playing sports. Paterno and colleagues found 23 patients in the ACL reconstruction group and four athletes in the uninjured group had an ACL injury during the year period. The overall rate of a second ACL injury within 24 months after ACL surgery and return to sports was nearly six times greater than the uninjured group. Overall, 29.5% of athletes had a second ACL injury within 24 months of return-to-sport with 20.5% having a new injury to the other side and 9% having a graft re-tear injury. More women (23.7%) had a new non-surgical side tear than men (10.5%). This begs the question of whether bio mechanical issues with the ACL repair side are leading to more stress on the other knee. I have discussed in the past that ACL repair surgery isn’t like the original equipment in that the grafts go in at a much steeper angle. Is this the cause of all of these second injuries? The ACL is also rich in position sensors that help guide the muscles of the lower body in accurate movement. Does ripping it out surgically get rid of all of that normal position sense and impact the other knee? A February study showed that patients with ACL injury had just as much loss of position sense in their good knee as their ACL injured knee, so what happens on one side seems to impact the other. The upshot? Getting one knee ACL “fixed” surgically appears to markedly increase the chance that the other knee will be injured. Is this due to the ACL injury itself or the ACL surgery? It could be either. I for one would rather try to heal the ACL (if possible) rather than removing it, as there is no ACL free lunch, meaning that removing the ligament and installing one that isn’t like the original equipment can’t be best option.
This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.
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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Shoulder
Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.
Many 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.
Knees 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.
Many 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.
Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
Hand and Wrist Arthritis
Carpal Tunnel Syndrome
Trigger Finger
Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
Hip 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.
Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
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