WHAT IF YOU COULD REGROW A TORN ACL?

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • A new technique pioneered by Boston orthopedic surgeon Dr. Martha Murray carries the promise of harnessing the body’s ability to heal a torn ACL through a minimally invasive approach
  • The technique is in the earliest phases of clinical testing, several more years will be required to prove the result
  • If successful, this technique could revolutionize the way we treat the torn ACL

By now most everyone involved in sports has heard about the dreaded ACL tear. The ACL ACL repair Murrayis a key stabilizing ligament in the knee, especially responsible for stability of the knee with forceful rotational movements. If your ACL is torn you’ll have an exceptionally difficult time returning to any sport requiring those types of forceful rotational movements, unless you have surgery to replace your torn ACL with a new one. We call this “ACL reconstruction”, meaning that we use another piece of tissue to create a new ACL.

The reconstruction works very well with generally excellent results. But there are downsides, such as the need to take a piece of tissue from somewhere in the body where it’s serving a perfectly useful purpose and putting it inside the knee. The recovery is long. For young athletes with open growth plates there’s a risk of growth disturbance.

What if the torn ACL could be repaired rather than replaced? For example, if you get a cut in the skin you can get stitches and eventually the cut skin is healed and turned into normal skin. Well the reality of the torn ACL is that the healing response and the environment on the inside of the knee are radically different than the surface of the skin. There have been many attempts at ACL repair over the course of the last several decades of orthopedic history, with generally very poor results.

But that may be about to change. At Boston Children’s Hospital, orthopedic surgeon Dr. Martha Murray has devoted much of her professional life to methods to repair rather than replace a torn ACL. She’s now completed an early trial of her method to use an absorbable scaffold infiltrated with elements from the patient’s own blood stream to regenerate a torn ACL.

Read about the trial and future plans in this article from the Boston Globe. And watch this brief excellent video about the Bridge Enhanced ACL Repair here.

This is potentially revolutionary stuff but we need a healthy dose of caution here because the research is in the very early phases. The early clinical trial was mainly focused on safety of the procedure with a very small number of patients (ten only). The next phase will start looking at a larger number of patients, about a hundred, and will require a few years of followup.

Aside from eliminating the need for a “graft” for the ACL reconstruction, a repair of a torn ACL has many other possible benefits. No need for the surgeon to drill tunnels through the bone, no risk to growth plates of growing youngsters, and possibly a faster return to sports.

There’s much yet to be proven but I have a hunch Dr. Murray and her colleagues are on to something big. We’ll keep a close eye on the results with great hope.

Boston Children’s Hospital ACL Repair Program