Award-Winning Research May Make ACL Healing Without Reconstruction Possible
Recent research, worthy of the 2013 Ann Doner Vaughn Kappa Delta Award, has produced promising results for the possibility of a "bio-enhanced repair" method to treat rupture of the anterior-cruciate ligament (ACL). Martha M. Murray, MD, and Braden C. Fleming, PhD, noting that more than 2/3 of patients who underwent ACL reconstruction developed osteoarthritis within 10-15 years of surgery, set out to develop a method of facilitating self-healing of the ACL as to avoid reconstruction and the associated long-term negative consequences.
The team first studied the natural healing processes of the ACL vs those of extra-articular ligaments, such as the MCL. While the two had comparable rates of proliferation, revascularization, and collagen production, the most noticeable difference was the lack of provisional scaffold in the ACL. The MCL created a bridge between the two torn ends of the ligament upon which the body could scar and construct a replacement ligament, but the synovial fluid that bathes the ACL washed the bridge away such that no regrowth could occur. In order to mimic this process seen in the MCL, and facilitate the same regrowth in the ACL, the researchers set out to engineer a scaffold that would allow the body to regrow its own ligament and eliminate the need for tendon graft reconstruction. Much like the scaffold implanted in the rabbits we read about in our first SNBAL, the researchers found the most effective method of promoting growth was to introduce specific enzymes, growth factors, and platelet-rich plasma along with the scaffold.
The mechanism was tested in a large-animal model and yielded promising results. Following FDA approval, the next step is to conduct clinical trials and hope this new method of treatment will provide a better option for those who suffer ACL rupture.
I found this article particularly interesting because I have had very considerable complications following the reconstruction of my ACL. Nearly two years post-op, I've undergone another surgery and am still not performing at the level I was pre-op. The development of osteoarthritis in my joint seems inevitable. Because I believe many of the complications I have encountered are a result of the invasive surgery, I am excited by the prospect of a new treatment option that would hopefully provide future patients with a greater chance of successful healing.
http://www.aaos.org/news/aaosnow/feb13/research7.asp
The team first studied the natural healing processes of the ACL vs those of extra-articular ligaments, such as the MCL. While the two had comparable rates of proliferation, revascularization, and collagen production, the most noticeable difference was the lack of provisional scaffold in the ACL. The MCL created a bridge between the two torn ends of the ligament upon which the body could scar and construct a replacement ligament, but the synovial fluid that bathes the ACL washed the bridge away such that no regrowth could occur. In order to mimic this process seen in the MCL, and facilitate the same regrowth in the ACL, the researchers set out to engineer a scaffold that would allow the body to regrow its own ligament and eliminate the need for tendon graft reconstruction. Much like the scaffold implanted in the rabbits we read about in our first SNBAL, the researchers found the most effective method of promoting growth was to introduce specific enzymes, growth factors, and platelet-rich plasma along with the scaffold.
The mechanism was tested in a large-animal model and yielded promising results. Following FDA approval, the next step is to conduct clinical trials and hope this new method of treatment will provide a better option for those who suffer ACL rupture.
I found this article particularly interesting because I have had very considerable complications following the reconstruction of my ACL. Nearly two years post-op, I've undergone another surgery and am still not performing at the level I was pre-op. The development of osteoarthritis in my joint seems inevitable. Because I believe many of the complications I have encountered are a result of the invasive surgery, I am excited by the prospect of a new treatment option that would hopefully provide future patients with a greater chance of successful healing.
http://www.aaos.org/news/aaosnow/feb13/research7.asp
posted by Debra Roussel at 3:58 PM
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