ACL Self-Repair Moving Toward Reality

Attempts by orthopaedists to repair torn human ACLs have failed for the most part, so surgeons now rely almost exclusively on removing the torn ligament and replacing it with autograft or allograft tissue. But now research at Harvard by Martha Murray, MD—a co-author of several JBJS studies—suggests that a torn ACL can be prompted to repair itself.

As Dr. Murray explains in a video, “bridge-enhanced” ACL repair uses stitches and a spongy scaffold injected with the patient’s blood placed between the torn ends of the ACL. The bridge helps healing clots to form and helps surrounding cells grow to rejoin the ends of the ligament. Preclinical studies using this technique have resulted in successful ACL repairs and rates of subsequent knee arthritis that were lower than those seen with reconstruction techniques. Bridge-enhanced ACL repair would also eliminate the need for tissue harvesting in the many patients who choose the autograft reconstruction option.

After reviewing the data from the preclinical studies, the FDA approved the first safety study of this technique in humans, which is now underway.

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3 responses to “ACL Self-Repair Moving Toward Reality”

  1. d cooper says :

    It’s from Harvard? I don’t believe a word of it. The ACL might form some scar tissue but its tensile strength will be gone. In addition, arthritis occurs in cases due to chondral damage at the time of injury independent of the ACL tear.

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  2. James Kayvanfar says :

    Most ACL tears heal & will function normally if protected with an immobilizer or a brace x 5-6 weeks, & then gradually rehabbed over 3-4 months.

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  3. Rob beattie says :

    Back in the 80’s we followed a series of over 100 primary arthroscopic ACL repairs done in selected patients that had proximal femoral side avulsions or near femoral side tears with sufficient length and substance to be considered for repair.They were often middle aged skiers and lower energy twisting injuries. The problem was a high failure rate of 25 % whereas reconstruction offered a failure rate of only 5-10%, so primary repair was abandoned. However I do recall that the successful ones( and we included 0 and 1+Lachman and negative pivot shift as success) had the best knees… very good satisfaction and function. Perhaps this was due to the preservation of the neuroproprioceptive fibers in the primary repair group.
    Successful primary repair is still the “holy grail”…but we need to overcome the significant failure rate.
    The augmented repair may indeed have potential merit but we will wait and look forward to seeing your definitive results. I truly hope it works
    Best of luck

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