Gold Standard for ACL Repair Unchanged
The American Academy of Orthopaedic Surgeons has noted previously that people who undergo anterior cruciate ligament (ACL) reconstruction are 15 times more likely to suffer another ACL injury within one year of surgery than are patients with an ACL injury who do not have surgery. Now, a study in the Clinical Journal of Sport Medicine identifies predictive factors of reinjury and graft failure of ACL reconstruction.
Researchers randomized 330 patients with ACL deficiency into three groups, based on which type of graft — patellar tendon, quadruple-stranded hamstring tendon or double-bundle hamstring tendon — was used in the follow-up repair. At two-year follow-up, researchers found that patellar tendon grafting, the gold standard for ACL repair, resulted in fewer traumatic reinjuries and complete traumatic reruptures; differences in atraumatic graft failures were not significant.
Regardless of graft type, younger age was identified as a predictor of traumatic reinjury, researchers found.
Tommy John Surgery Increasingly Common among Youth
The prevalence of ulnar collateral ligament reconstruction (UCLR), commonly known as Tommy John surgery, is on the rise, as any baseball fan likely knows. But few — including medical practitioners — are aware of the incidence rates and demographics associated with the surgery.
In a retrospective literature review — the first to delve into the demographic distribution of Tommy John surgery, according to its authors — in the American Journal of Sports Medicine, researchers examined the rising number of UCLR operations performed between 2007 and 2011. Among their key findings:
- During the study’s time frame, nearly 57 percent of UCLR surgeries were performed on patients who were between 15 and 19 years old. The incidence rate for patients in this age group rose an average of 9.12 percent annually.
- Almost 700 males underwent UCLR, compared with 95 females.
- More UCLR operations were performed in the South than in any other region of the United States.
Study Questions Value of PRP Injection for Injured Athletes
One injection of platelet-rich plasma (PRP) does little to hasten certain injured athletes’ return to sports when compared with intensive physiotherapy alone, according to an article in the British Journal of Sports Medicine. The study’s findings corroborate those of an expanding body of literature showing limited efficacy of PRP injections in the treatment of musculoskeletal soft tissue injuries.
The majority of the study’s 90 participants were male professional soccer players who had suffered acute hamstring injuries. One group had a PRP injection and rehabilitation; another had only rehabilitation.
“Our findings indicate that there is no benefit of a single PRP injection over intensive rehabilitation in athletes who have sustained acute, MRI positive hamstring injuries,” the authors write.
Researchers also compared reinjury rates among the study groups, finding no statistically significant difference at two or six months.