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

The Hidden Risk of Running a Marathon

Close up of trainers running through mossy terrain

Running is a great workout, and it comes with all of the heart-strengthening benefits of aerobic exercise. But doing it for long distances—like in a marathon—may come with unintended health consequences. A small new study finds that marathon runners can experience short-term kidney injury after the race.

In the study, published in the American Journal of Kidney Diseases, researchers took blood and urine samples from 22 people who ran the 2015 Hartford Marathon, and looked for evidence of kidney injury. The researchers reported that based on the markers they observed in the samples, 82% of the runners had evidence of stage 1 acute kidney injury after the race. The problem appeared to be short-term, and most people’s kidneys returned to normal within 24 to 48 hours.

Still, the researchers say that their findings underline the fact that running a marathon is a stressful event for the body, and that some people may want to be extra vigilant. “We knew we would find something, but I was surprised by the level [of injury],” says study author Dr. Chirag Parikh, a professor of medicine at Yale University. “It’s comparable to what I see in hospitals.”

More research is needed, but Parikh says that people who have no risk factors for kidney disease probably don’t need to worry. People with diabetes or high blood pressure, or people who are older, may want to work closely with trainers and doctors to keep an eye on their kidney health if they’re running marathons.

Though the researchers did not determine how exactly running a marathon can temporarily hurt kidneys, Parikh says the damage may be due to less blood flow to the kidneys, high core body temperature and dehydration. It’s still unknown whether this short-lived kidney injury can cause cumulative damage, or if some people may not recover in the short-term.

The study is not the first to find that marathons can come with health risks. While it’s clear that getting exercise is important, research suggests that more isn’t always better. A 2015 review published in the journal Current Sports Medicine Reports found that while runners in the study lived longer than non-runners, men and women gained the lifesaving benefits of running if they ran at slow or moderate speeds for about one to two hours a week. Among the runners, the people who ran the most had worse survival rates than people who ran less.

Parikh says that his study did not identify who might be at a higher risk, but notes that people over age 40 are increasingly signing up for marathons, and may want to take more precautions. Today, people 40 and older make up nearly 50% of marathon finishers in the U.S., compared to 1980 when this age group made up just 26%.

“Is there a right amount of distance for each person?” says Parikh. “Like everything else, there might be a balance of the benefits and risks. People can find the right distance for them and train their body.”

By Alexandra Sifferlin for Time Health

Dr. Cole’s Knee Injury Guide APP Just Released

iPhone Screenshot 1The BrianColeMD KneeGuide is your very own personalized Injury app for your pocket. The app provides users with detailed information, treatment and identification of the most common knee injuries treated everyday by Health Professionals worldwide. Within the app you will find a vast array of strengthening and flexibility exercises that have been specifically designed for injury treatment and rehabilitation. The app has been created with the user in mind to make it simple and easy to navigate around so you can manage your injury effectively. Below you will find detailed information that you will get from the BrianColeMD KneeGuide.​

iPhone Screenshot 2Injury Identifier

The injury identifier feature found within the app allows users to filter through a variety of descriptions that could possibly identify the knee injury that you are suffering from. When selecting the area of pain the user is prompted with a detailed description of specific symptoms that would be associated with a particular knee injury. The user is prompted to select the symptoms that best describes what they are feeling. It is important to note that this does not replace personal one on one consultation with a qualified health professional.

iPhone Screenshot 3Injury information

Each and every injury found within the app has a vast amount of vital information that aims to educate and inform users of their specific injury they are suffering from. For each injury you will find:

  • Detailed Injury Image
  • Detailed Injury Description
  •  Common injury causes
  • Common signs and symptoms
  • Common healing times for the injury
  •  Helpful tips to minimize injury aggravation

iPhone Screenshot 5Treatment

For each and every injury found within the app you will find specific treatment guidelines for specific stages of your injury treatment. These treatment stages are broken down into first 48-72 hours after injury, 3-5 days after injury, 7-14 days after injury and 3 weeks + after injury. Within each of these stages you will find specific strengthening and flexibility exercises commonly used to treat specific injuries. However, it is important that your Health Professional approves the application of these exercises for your injury recovery before performing any self treatment.

Exercises

Within the app you will find a vast amount of injury specific exercises that help you improve your strength and flexibility during your injury treatment and rehabilitation. All exercises found within the app have retina display images of how to perform the exercises, explanation of the exercise such as reps and sets and the purpose and also detailed written steps. You will also find out the specific and additional muscles that are involved in the exercise. Furthermore you will find “Tips” information that helps you improve the effectiveness of each particular exercise.

My Program

The my program feature allows users to save specific strengthening and flexibility exercises along with specific taping techniques to the my program tab. When used in collaboration with your Health Professional you can create a rehab program specific to your injury recovery phase. Health Professionals can use the my program feature to create rehab programs for their clients and use the export feature to email a list of exercises found in the app that they should be performing for their injury recovery.  

Note: It is important that your Health Professional approves the application of all exercises for your injury recovery before performing any self treatment. It is important to note that any information found within this app does not replace personal one on one consultation with a qualified health professional and the user uses this app at their own risk as it is for educational purposes only.

  

Related: Shoulder Injury Guide APP

Golf Training; OTC vs Rx Medications for Pain; Kettleball Training

Episode 17.09 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.new host image

Dr. Nikhil Verma from Midwest Orthopaedics at Rush is filling in this week for Dr. Cole.


Segment One (02:14): Joe Estes from Athletico Physical Therapy talks with Steve and Dr. Verma about preventing Golf Injuries, proper warm up routines and the new indoor simulator at Athletico’s Golf Performance Center in Oak Brook that proudly uses the innovative K-Vest to improve the game for professional and amateur golfers.

The technology behind the K-Vest is a three-sensor wireless system that strategically places sensors on a golfer’s hips, shoulders, and hand to measure motion during a golf swing.  The sensors immediately communicate to a computer a 3D analysis.  This analysis allows the instructor to instantly address critical aspects of a golfer’s body such as hip rotation, speed, sequence and timing.


Segment Two (12:55): Dr. Verma and Steve discuss OTC vs Rx Medications; risks ofRelated image addiction, non-drug alternatives and guidelines for use of OTC pain medications. Dr. Verma is Professor and Director, Division of Sports Medicine, Fellowship Director, Sports Medicine, Department of Orthopedics, Rush University Medical Center. Dr. Verma specializes in treatment of the shoulder, elbow and knee with an emphasis on advanced arthroscopic reconstructive techniques of the shoulder, shoulder replacement, knee ligament reconstruction and articular cartilage reconstruction and meniscal transplantation.

U.S. News & World Report ranks the orthopedic program at Rush University Medical Center #4 in the Nation and the highest ranked program in Illinois.


Segment Three (20:00): Gerard Iaculo from Jim Karas Intelligent Fitness & Wellness talks with Steve and Dr. Verma about the use, history and benefits of Kettlebell training.

At JimKaras.com, training is grounded in timeless training principles and has over thirty years of experience recognizing the legitimate innovations in our industry that burn fat (NOT MUSCLE), improve functional performance and decrease your risk of any injury.