Replace the ACL? More Research

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Torn ACL Symptoms and New Research on ACL Replacement Outcomes

If you follow our blog, you’ve read a lot recently about torn acl symptoms and our approach towards non-surgical ACL repair (anterior cruciate ligament). There’s a real controversy brewing over whether to replace the ACL when it’s completely torn or just leave the torn ligament. One recent study suggested that no matter what you do, the patient will get arthritis at about the same rate. However, this recent study out of Croatia would suggest that replacing the ACL is beneficial and that operated patients show less evidence of long-term arthritis in 94% of the patients treated. So who’s right? The studies were designed differently, so we may never know. It does make sense to us that restoring stability in a knee without an ACL ligament is likely a good thing, while leaving a joint unstable over a long period will cause more wear and tear arthritis in the knee. These concepts are discussed further in our medical practice’s book, Orthopedics 2.0. In our experience, if the ACL ligament is completely torn and retracted (meaning the two ends no longer connect and are pulled back, like a broken rubber band), then we would recommend reconstructing the ACL surgically. However, if the knee ACL is simply stretched and torn, but is still connected, then injection-based regenerative medicine options should be tried first. Is there evidence that injections can tighten the ACL? Yes, Reeves published a pilot study about 10 years ago, showing objective evidence that injections can reduce instability in a knee when the ACL is lax. So should you get knee ACL surgery? It depends on what type of ACL tear you have. However, the jury is still out on whether knee ACL surgery helps long-term to prevent arthritis.

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. View Profile