6 insights on ACL surgery: Dr. Andrew Pearle discusses

Written by Alan Condon | August 06, 2019 | Print  |

Andrew Pearle, MD, is director of the computer assisted surgery center at Hospital for Special Surgery in New York City and editor-in-chief of the Orthopedic Journal Techniques in Knee Surgery.

Dr. Pearle outlines six details patients should know about anterior cruciate ligament surgery.

1. Reconstruction involves a graft placed in the knee using tiny incisions and is the standard of surgical care for ACL tears.

2. Roughly 300,000 ACL reconstructions are performed in the U.S. annually.

3. ACL repair is an older method that sewed torn ACL tissue but was abandoned due to failure rates of up to 50 percent. However, a minimally invasive approach to ACL repair is now possible.

4. It is crucial to get ACL surgery right the first time as revision requires reconstructive ACL surgery with a graft, which may result in increased failure rates and higher risk of osteoarthritis.

5. Modern studies show ACL repair failure rates are vastly higher than ACL reconstruction failure rates. A study titled "ACL repair with suture ligament augmentation is associated with a high failure rate among adolescent patients," published in The American Journal of Sports Medicine found that arthroscopic ACL repair has short-term failure rates of almost 50 percent in young athletes.

6. There is still a lot to learn about ACL repair. No scientific evidence demonstrates a difference in postoperative pain between ACL repair and reconstruction. Dr. Pearle says rehabilitation and return-to-play guidelines need to be established for ACL repair.

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