ACL surgery may be what knees need

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Tears of the anterior cruciate ligament, one of four main knee ligaments, are all too familiar to serious athletes and even weekend warriors. ACL tears commonly happen when the knee is hyperextended during activity, or is suddenly torqued.

Two recent studies present new takes on ACL surgery and recovery.

NFL players who underwent ACL surgery had longer careers than their peers who had meniscus repairs, or who underwent both procedures. Researchers analyzed a database of NFL player injuries from 1987 to 2000 and found 54 who had had meniscus repairs, 29 with a history of ACL reconstruction, and 11 with a history of both. They were matched with a control group with no prior surgeries and matched by position, year drafted, round drafted and other injury history. ACL surgery alone didn’t substantially shorten the careers of the players, either by year or game number. However, the careers of those who had had meniscus repairs shrunk were about 1.5 years shorter, or 23 games. And players who had both procedures had careers cut by almost two years, on average, and 32 games.

‘A combination of ACL reconstruction and meniscectomy may be more detrimental to an athlete’s durability than either surgery alone,’ said lead author Dr. Robert Brophy of the Washington University School of Medicine, in a news release. ‘With further research, we will be able to better understand how these injuries and surgeries impact an athlete’s career and what can be done to improve long-term outcomes.’

ACL surgery in young athletes is becoming more common. But some health experts (and parents) worry that such surgery could carry risks because bones haven’t finished growing. But a new study suggests that delaying surgery might have even worse consequences. Researchers examined records of 70 children 14 and younger who had ACL reconstruction surgery between 1991 and 2005. A little less than half (29) who put off treatment for more than 12 weeks had four times as many medial meniscus tears, 11 times as many lateral compartment chondral injuries, and three times as many patellotrochlear injuries. They also had more instability in their knees.

Both studies were presented this week at the annual meeting of the American Orthopaedic Society for Sports Medicine in Keystone, Colo.

-- Jeannine Stein