ACL Protection & Injury Prevention
ACL INJURY: FACTS & FIGURES
Incidence
Risk of ACL injury to contralateral knee is 2 TIMES that of the reconstructed knee.
• Over two million ACL injuries occur worldwide annually. 1 • 50% of ACL injuries occur in 15-25 year olds 2 • 60-80% of ACL injuries are non-contact related 3 • Women are 2-10x more likely to injure ACL 4
Re-injury
• The re-injury rate for the ACL reconstructed knee is 5%-10% 5 • Risk of ACL injury to the contralateral knee is double that of the reconstructed knee 5 • Only 1/3 of reconstructed athletes attempt to play competitive sports at their pre-injury level within one year following reconstruction 6 • 1 in 5 active reconstructive athletes develop new injuries 6 • Fear of re-injury prevented competitive college and high school football players from returning to play 7
Biology of graft healing
Final ACL graft strength is 67% of a normal ACL
100 %
Collagen mature
Avascular necrosis
Remodeling & Proliferation
Revascularization
50 %
50 %
Disorganization of collagen
Use of a brace until 24 weeks post-op is recommended
2 4 6 8 101214 1618 2022 24 262830 32 3436
capillarization begins
revascularization completed
Weeks Postoperative
Fig. 1: Revascularisation of an ACL graft
• Immediately following ACL surgery the graft is at its strongest, graft strength quickly declines due to avascular necrosis. • Graft healing research indicates that the graft is most vulnerable to injury around 6 to 8 weeks postop. Between the third and the 20th week after operation the revascularisation process takes place. Proliferation and remodelling of collagen only occurs as from 12 weeks post-operative. • Protection of the ACL graft with a brace is recommended until 24 weeks post-op to ensure maximum healing. 8,9,10,11,12,13
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