ACL tear surgery or not? Most people believe that getting their ACL reconstructed after a torn ligament is like having a worn-out part replaced in their car. Nothing could be further from the truth. Now, a new study shows yet another reason why an ACL surgically “repaired” knee is not like the original equipment.
The Problems with ACL Surgery
The pitfalls of ACL surgery aren’t new to this blog; I’ve covered many other research articles in the past. Here are some links that summarize the published research on why ACL surgery isn’t all it’s cracked up to be:
- The new ligament is installed at a steeper angle, making the repaired ligament have nowhere near the original function as the original ACL.
- It’s six times more likely that the operated or opposite knee will sustain a tear following ACL reconstruction.
- ACL surgery doesn’t prevent knee arthritis, and it may accelerate it.
- Eight months following ACL surgery, fewer than 1 in 5 athletes are ready to return to sports.
- While many professional athletes believe ACL surgery will lengthen their career, the data shows that it shortens it.
- ACL surgery can leave the knee joint rotationally unstable.
- After an ACL surgery, there is a loss of normal position sense in the knee.
The New ACL Study
New research should help you answer the question of ACL tear surgery or not by evaluating how the procedure changes the way patients land. The study looked at how landing mechanics change in patients after ACL surgery between 6 months and 12 months after surgery. Regrettably, the vast majority of forces and angles that the team measured upon landing a jump were still abnormal and not like the uninjured knee at 12 months. Hence, the researchers concluded that ACL surgery likely permanently altered the patient’s ability to land (or at least if it ever returns to normal, it’s after more than a year).
Given that many high-level athletes who jump and land are released back to their sports at one year, it’s scary to think what can happen to the hip, knee, and ankle over the long run due to these abnormal mechanics. Why is this happening? The new replacement ligament goes in at a different angle, is usually only single-bundle versus the natural double-bundle configuration, and doesn’t have the same ability to provide position sense to the body upon landing.
Is There a Better Way?
One way to answer the question of “ACL tear surgery or not” is to avoid the surgery by using the power of your body to heal the tear. In our extensive experience, about 70% of ACL tears that currently get surgery could have been treated with a precise injection of stem cells instead. This procedure is highly technical and requires advanced injection skills using X-ray guidance, but we’ve seen it take ACLs that have been read out on MRI as completely torn and return them to a normal MRI signal, tighten them down to normal levels, and reduce pain while increasing function.
The upshot? Getting your ACL replaced permanently alters the mechanics of the knee joint. This new study is just one of many that show that these surgically reconstructed knees are never like the original equipment. Hence, if you’re in the lucky 70% of ACL tear patients who are candidates to use a precise stem cell injection to heal the ACL inside the knee and keep their original ligaments, why wouldn’t you try to go that route?