The ABC's of ACLs

The anterior cruciate ligament (ACL) runs diagonally in the middle of the knee and controls the back and forth motion of the knee (OrthoInfo, 2014). A tear in this ligament often occurs due to stress on the ligament, specifically Athletes have ACL injuries because they often occur during anything that involves sudden stops or changes in direction (Figure 1). Depending on the sport, professional athletes can have a greater or smaller risk of tearing their ACL. From 2010 to 2013, of the 219 NFL players that suffered ACL tears, 18% had a previous history or ACL injury and 12% experienced retears. In the NBA, the risk of ACL tears has been a bit lower. In a Stanford study from 2021, researchers found between 3.8-5.2% of players experienced ACL tears depending on their career drive (Stanford 2021). In European soccer, this rate has been reported even lower at 1.2% (Italian Football research group, 2022). Despite the rates of tears, however, recovery to pre-injury levels can vary widely depending on the sport. Even though it can happen, many of these athletes cannot go back to their original form and play at the level they used to.

Fig.1: A diagram of the Anterior cruciate ligament (ACL) and an ACL injury

There is a lot of research being done on ACL injuries currently,. However, There have been several instances where the ACL reconstruction process is a tricky one and can result in partial or failed has not fully treatedment of the tear. Many athletes also reinjure their ACL even after full recovery from of the ACL reconstruction. In fact, only about 40% of patients completely heal after an ACL reconstruction (ref). Since research shows that these ACL transplants risk stability of the knee joint, scientists have looked into other options like arthroscopic primary ACL repair (Kiapour Am, Fleming BC, Murray MM). In thise end study, they outlined came up with four different operative techniques under development: the dynamic intraligamentary stabilization (DIS) with Ligamys™, the Bridge-enhanced repair (BEAR), the use of internal brace, and the fixation with suture anchors (Kiapour Am, Fleming BC, Murray MM). Based on the existing trials of each technique however, there is not enough evidence to use the bridge-enhanced ACl repair, internal brace, or suture anchors as common treatment options yet. This is because the existing clinical trials we do not hold enough credibility to apply it to patients. [add a sentence about why not? Have there not been enough patients to study this treatment, or were there unforeseen side-effects/consequences?].THowever, the dynamic intraligamentary stabilization (DIS) with Ligamys, however, has shown the best results. Around 80% of ruptured ACLs were successfully repaired. [what were the results? Insert a statistic here]. The idea of the DIS treatment is to continuously stabilize the knee while improving the environment that allows for the ACL to heal itself.

Fig 2: Dynamic Intraligamentary Stabilization