Tuesday, December 13, 2011

What We Don't Know about ACLR: Graft Maturation

       We have talked about rehabilitation after ACL surgery. However, there are many things that are not clear to us. What we know is based on clinical trials and studies done in the past and their results are consistent. When it comes to how ACL grafts go through maturation process, it is not that clear. Once ACL graft is in place, it goes through a process of vascularization and maturation. We do not know at what point the graft is strong and mature enough to do what. All we know is that we have been successful rehabilitating those patients following protocols (to note, there are a bunch of different protocols). And time to return to sport has shortened. But we do not know whether it is safe and healthy to a graft.
       A study took a look at when ACL grafts finish their vascularization process based on MRI. It showed that it might take up to a year for the grafts to vascularize. Once again, we do not know if it is safe to return the athletes to sport before the vascularization process is finished. One thing to note is that studies done in Indianapolis using accelerated rehabilitation protocol showed that up to 20% of athletes younger than 18 years of age re-injured or tore ALC after returning to sport.
      There have been so many studies done on ACL tears and rehabilitation. However, this stays as a hot topic in sports medicine. One reason probably is that there are so many things we do not know yet.