Lesser-Known Knee Surgery May Prevent Total Knee Replacement

High Tibial Surgery for Younger Patients

A new study has revealed that a lesser-known knee surgery may prevent total knee replacement. The findings of the study, published within the Canadian Medical Association Journal, prove promising for younger patients.

The surgery, known as High Tibial Osteotomy, was shown to significantly reduce the need for a total knee replacement in younger patients. So, what is this lesser-known knee surgery and what did the study show?

High Tibial knee surgery

High Tibial Osteotomy is used on younger patients in the early stages of osteoarthritis. The procedure was first performed in the 1950s and it aims to shift the weight away from the damaged part of the knee. This helps to greatly reduce pain and improve the function of the joint.

In the procedure, the shinbone is cut and then reshaped. As well as helping to relieve pressure on the damaged joint, the surgery can also help to correct poor knee alignment. The aim is to prolong the joint and reduce the need for a knee replacement.

Those under the age of 60 with damage only to one side of the joint are ideal candidates for the procedure. Like any surgery, there are risks and complications. The surgeon will talk through the risks during your consultation.

Understanding the recent study

The recent study was carried out at the Faculty of Health Sciences and the Bone and Joint Institute at Western University, Canada. Led by Dr Trevor Birmingham, the study looked at patients who had undergone a High Tibial Osteotomy using the medial wedge method, from 2002-2014. They looked at the incidence of total knee replacements in July 2019.

There were 556 patients included in the study, who had collectively undergone 643 High Tibial Osteotomy surgeries. The rate of total knee replacements after five years was 5%, rising to 21% after 10 years. This shows that the procedure protects the knee for longer than 10 years in most patients.

Several risks for a total knee replacement were also identified. These included the severity of the osteoarthritis, pain, gender, BMI, and age. It was discovered that more women patients went on to require a total knee replacement. Younger patients who aren’t very active also have an increased risk. These risk factors will help surgeons and physicians determine its suitability for patients.

Is High Tibial Osteotomy the best option younger patients?

While High Tibial Osteotomy surgery is used on younger patients, many surgeons have been reluctant to carry out the procedure. This is because they believe it is better to opt for non-operative treatments while waiting for total knee replacement surgery.

This new study shows the effectiveness of treating younger patients with a High Tibial Osteotomy. With results lasting over a decade, it is an effective way to eliminate the pain associated with osteoarthritis. To discover whether this type of surgery would be effective for your osteoarthritis, call  08450 60 44 99 to book a consultation at our London or Bristol knee clinics.

Steroid Injections Found Not to Hasten Need for Knee Replacement

Steroid Injections and Knee Replacements

Steroid injections are commonly used to relieve osteoarthritis pain. However, past research has suggested they could speed up the need for a total knee replacement. This has understandably led to some specialists seeking alternative treatment options for patients.

Now, new research has revealed steroid injections do not hasten the need for a knee replacement. Below, we will look at what the latest study found and what it means for patients.

Study into steroid injections and knee replacements

The new study was carried out by researchers at the Boston University School of Medicine. The goal was to identify whether corticosteroid injections used to treat knee osteoarthritis, sped up the need for a knee replacement. In previous research, it was stated that the injections tripled the risk of a total knee replacement. The trouble is this was based on patients with more advanced knee osteoarthritis.

The new study compared corticosteroid injections to hyaluronic acid injections. Two large cohort studies were used, with one group receiving corticosteroid injections and the other receiving hyaluronic acid injections. Rates of total knee replacement and radiographic progression or joint damage on X-ray’s were reviewed. In total, the study included 792 knees. The majority (647) received corticosteroid injections, while the others received hyaluronic acid injections.

It was discovered that total knee replacements were more prevalent in the group who had received hyaluronic acid injections. Both groups had similar rates of X-ray progression. This showed patients who do receive corticosteroid injections are not at a higher risk of requiring a total knee replacement.

What is knee osteoarthritis?

Knee osteoarthritis is a wear-and-tear type of arthritis. The disease worsens over time and is most common in patients aged 50 and over. It typically results in bone rubbing on bone, which can cause a lot of pain and stiffness within the joint.

As the disease progresses, patients may find it increasingly difficult to carry out daily tasks. That is when a total knee replacement is often required. Initially, the condition can be treated with physiotherapy and medications. Corticosteroid injections are also a common treatment option, despite the controversy that has surrounded them due to past research.

Are steroid injections a safe option?

The latest research does suggest steroid injections are safe to use to treat knee osteoarthritis. The previous studies which linked the injections to an increased risk had focused on patients with the most advanced knee osteoarthritis. This could mean that they were due to need a knee replacement soon anyway. The latest research in contrast, assessed patients who weren’t in the advanced stages of the condition.

Corticosteroid injections can prove invaluable for relieving pain associated with knee Osteoarthritis. The results of the latest research will be welcome news to patients who may worry about the risks. Having the injections won’t speed up your need for a knee replacement, but they will make the pain more manageable.  

For more advice on both non-surgical and surgical treatment options for knee osteoarthritis, call 08450 60 44 99 to arrange a consultation with Mr Jonathan Webb at his Bristol Clinic or 0203 195 2443 to book an appointment at Fortius Clinic in London.

Study Evaluates the Long-Term Outcomes of Meniscectomy

meniscectomy

A meniscectomy is commonly used to treat a torn meniscus in the knee. However, some experts in the field believe it offers little in the way of benefits for patients. Now, a new study carried out by Italian researchers, has evaluated the long-term outcomes of the procedure.

Here, we’ll look at what the study found and whether or not a meniscectomy is a beneficial treatment for patients suffering with a torn meniscus.

Understanding the study

The retrospective study included 289 patients aged 50 to 70 who had undergone an arthroscopic meniscectomy after being diagnosed with a degenerative meniscal tear.

Data was collected regarding patient age, sex, knee alignment and osteoarthritis. A follow up was provided 20 years after the procedure. It revealed that older age, being female, lateral meniscectomy and advanced chondral lesion were increased risk factors for requiring total knee replacement surgery after an arthroscopy meniscectomy.

A total of 15.7% patients went on to require a total knee replacement after a meniscectomy procedure. The time between surgeries was typically seven years. So, while an arthroscopic meniscectomy does present a risk of the need for a total knee replacement later on, in most patients it does seem to prove to be an effective option.

What is a meniscectomy?

A meniscectomy is a surgical procedure which removes either the entire, or part of the meniscus.

The meniscus is cartilage within the knee, which absorbs shock as well as lubricates, protects and supports the bones of the joint. Each knee contains two menisci, one on the inner and one on the outer section of the joint. Like any part of the body, these can become damaged over time, with meniscus tears proving particularly common.

In most cases, a partial meniscectomy is carried out in order to try and preserve as much of the cartilage as possible. Studies have shown that when a total replacement surgery is carried out, it increases the risk of the patient developing arthritis in 10 years’ time.

A meniscectomy aims to repair a moderate to large meniscus tear, typically situated on the outer area of the joint. There are different types of tears you can experience and not all of them require a surgical approach.

Other meniscus treatment options

Small meniscus tears don’t necessarily need treatment. They often heal by themselves after plenty of rest at home. If you have a large tear which crosses most of the meniscus, surgery may also prove to be ineffective.

Non-operative treatments include physical therapy, anti-inflammatory medications and strengthening exercises. If surgery is required, an alternative to a meniscectomy is a meniscus repair. The rehab process will be a little more extensive for a repair surgery than a meniscectomy. This is because the torn muscle still needs to heal, whereas with a meniscectomy it is removed.

Before selecting any treatment for a torn meniscus, it is important to talk through your options with a qualified surgeon. They will be able to recommend the best treatment based upon your diagnosis.

When the knee surgeon becomes the patient: my knee replacement recovery diary

My knee replacement recovery diary

Leading London and Bristol knee surgeon Mr Jonathan Webb found himself in the unique position of becoming the patient when he recently decided to undergo knee replacement surgery. After injury his knee playing rugby for England in the early 90s, he underwent a meniscectomy and for many years remained pain-free and very active.

However, in the last five to seven years, Jonathan experienced increasing pain and lack of mobility as he developed knee osteoarthritis. So, he decided to undergo a robotic total knee replacement at the Fortius Clinic in London. Here he details his road to recovery.

Day 0:
Have been able to sit with the knee resting into extension most of the time. Occasional rest slightly flexed and generally has been bearable with just a strong sense of tightness. Never realised how effective IV paracetamol was!

Midnight – Spinal finally wore off. Pain now 4/10 with some stinging around the incision and just a sense of tightness but still able to do a straight leg raise.

Unable to pass urine. Been 8 times to bathroom between 2am and 6am before finally managing. Really didn’t want a catheter!

Day 1:
Swelling increased steadily and ability to do straight leg raise disappeared.

Practiced walking with crutches, feels very uncontrolled, especially the ability to straighten knee. Not been able to do that for years.

Pain pretty strong, helped by regular pain killers and ice. Trying hard to rest with knee in extension, stretching posterior capsule. Walked around ward and did stairs.

Night better but difficult to find comfortable place to rest knee. Fine if you lie on my back but who sleeps like that 😳

Day 2:
Better sleep so able to do a few static quads and straight leg raises today.

Have to remind myself to stand on 2 legs with knee extended. Clearly been relying on left for long time. Much more secure when quads engaged.

Did stairs independently so went home at 11am, 46 hours after surgery.

Slept better in 2 hour bursts.

Day 3:
Icing 8x 30 mins

Trying to do exercises as often as possible. Swelling means flexion only 60 degrees.

Able to walk around house without crutches.

2 weeks:
Whole leg swollen and bruised, from top of thigh down to ankles.

Using the Game Ready knee wrap, which combines Intermittent Compression with Cold Therapy, 3-4 times a day, very helpful. Cannot imagine what it would be like without one!

Flexion still only 60 degrees but extension becoming more comfortable. The lack of bend is worrying me but Andrea, my very experienced Physiotherapy colleague, keeps reassuring me it will be fine, and then goes and ‘assists’ my flexion to excruciation!

Able to walk without crutches but tends to swell more so have continued to use them.

Still requiring strong painkillers most of the time.

3 weeks:
Able to do short flat walks of around 20-30 minutes. Not much in the way of painkillers during the day, started driving short distances. This was on the basis that I could stamp my right foot on the ground hard and I had a practice drive in a car park doing an emergency stop without pain.

Night pain causes me to wake between 2-4 times. I try and store as many painkillers for the night as I can out of my 24-hour quota.

Hands on deep tissue massage very beneficial to stiffness, swelling and flexibility. Highly recommended!

4 weeks:
Still getting moderate swelling by mid morning. Gone overnight.

No painkillers during day, back to work half time. Knee swollen and stiff after operating lists.

Stopped using the Game Ready.

5 weeks:
Full working week.

Knee fine during day but has started being very sore up, and especially down, stairs. Probably related to less time doing my exercises as back at work.

6 weeks:
Overall I’m struck by the variety, unpredictability and at times, severity of the different pains the knee has had throughout recovery. Quite often not related to what I do and often I, the supposed expert, have no idea what causes them.

Pain on stairs miraculously helped by very old school 60 minute soft tissue work done by Physiotherapist.

8 weeks:
Real transition to minimal pain on walking, even up stairs.

Flexion now 120 degrees.

No night pain at all. Still getting a sciatica type pain when driving for more than 30 minutes.

Knee still very stiff if I’ve been standing operating for more than a couple of hours.

10 weeks:
Played 3 rounds of golf in 2 days. In buggies but still walking around 4K per round. No pain. Golf unaffected. Won 2, lost 1!

4 months:
Minimal pain.

Still a limit to how much strengthening I can do but walking pretty unrestricted ie 2-3 hours wouldn’t be a problem albeit with an ache afterwards.

5 months:
Started road cycling during lockdown and as principle means of cardio fitness. Knee really responds well. If a little stiff at start then it frees up with the movements by end of a ride, managing up to 30K+. Getting my heart rate up to max for first time for maybe 18 months.

6 months:
Still some clicking with certain manoeuvres especially coming up stairs as I lift my right knee up from a lower step to put it on a higher step. Suspect this will be permanent

9 months:
Virtually never experiencing any pain. Would have to really push the knee hard on uneven ground, long day standing or heavy weights to get a reaction. Bend is only about 15 degrees less than the other side. Leg press 10% down compared to left knee.
Still tender to kneel on it but not that different to other knee.

12 months:
Near normal. Very occasional twinge from the outer top of shin bone if I twist awkwardly getting out of the driver’s seat of the car.
However I can push leg weights in gym with impunity, flexion still improving bit by bit. Hiking and cycling unlimited by the knee, just my lungs/stamina.

In summary: Life changing.

How to Manage Your Knee Arthritis This Winter

knee arthritis in winter

During the winter, patients suffering with knee arthritis may experience a worsening of the condition. When the temperature starts to drop, it can feel like the joints are much stiffer and more painful.

So, is knee arthritis impacted by colder weather and how can you manage your symptoms if it is? Here, you’ll discover everything you need to know about how the weather can affect the condition and what you can do to manage it.

How does temperature affect knee arthritis?

Various studies have confirmed that changing temperatures and weather conditions can affect the symptoms of knee arthritis. Manchester University recently carried out a study which was funded by Versus Arthritis, which revealed those living with arthritis experienced increased pain on windy, humid days.

However, when it comes to linking the cold with increased knee arthritis pain, there is no scientific evidence to back it up. An increase in joint stiffness during colder weather could actually be more down to a lack of activity. We tend to become more sedentary when it is colder outdoors. When you suffer with knee arthritis, long periods of inactivity are going to ultimately increase the stiffness of the joint.

Another theory as to why some patients do experience increased pain in winter, is that pain receptors are more sensitive to cold. This means, in colder temperatures, you may notice the pain caused by knee arthritis more than you would in warmer weather.

So, the cold won’t worsen knee arthritis, but it can make the condition feel more painful.

Ways to manage the condition in winter

If you suffer with knee arthritis, there are things you can do to manage the condition in winter. These include:

  • Wearing compression style clothing
  • Pain medication
  • Steroid injections
  • Physical therapy
  • Vitamin D supplements

Compression style clothing, such as leggings, can help to support the joint, as well as keep you warmer than loose fitting clothing. It is also known to reduce inflammation, resulting in less pain.

You can also talk to your doctor about increasing your pain medication during the winter. Non-steroid based pain medications could help to make the condition more manageable in winter.

If you find the condition is very painful in colder weather, steroid injections may help. This treatment lasts potentially months, so it could be an effective way to ride out the winter months in comfort.

Physical therapy can also prove effective. Not only can it reduce pain, but it can improve mobility too. Finally, increasing your vitamin D consumption can also help. In winter, vitamin D levels drop due to decreased sunlight. The vitamin has been shown to help reduce pain in arthritis patients. Taking a supplement in the winter months can help to keep levels topped up and decrease joint pain.

The above are some of the best ways to manage knee arthritis in colder weather. However, if the pain is severe or you do notice it worsening, book a consultation with a knee specialist. You may need to undergo a knee replacement surgery if the condition is deteriorating.

It’s Just Not Tennis: Racket Sports May Make Knee Arthritis Worse

tennis makes knee joint degeneration worse

A new study has revealed that racket sports may make knee arthritis worse in patients who are overweight.

While physical activity is generally encouraged to those who are overweight, this new research shows not all types of exercise are suitable. Here, we’ll look at what this latest research revealed, and which types of exercises are safer for overweight patients.

What did the study into knee joint degeneration reveal?

A high-powered MRI was used during the latest study to look at the rate of knee joint degeneration. The study included 415 obese or overweight patients, with an average age of 59.

The participants in the study were asked to keep a record while carrying out six different types of exercises. These included running/jogging, swimming, ball sports, elliptical trainer, bicycling and racket sports. Baseline MRI’s were carried out before a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) was used to measure changes within the patient’s knees over a period of four years. The higher the WORMS score, the more degeneration has occurred.

It was discovered that patients who participated in racket sports, saw their WORMS score increase dramatically. Racket sports were shown to have more damaging effects on the knees than running or jogging. Interestingly, patients using an elliptical trainer saw the lowest level of degeneration in the knee.

What is knee arthritis?

Knee osteoarthritis is a degenerative type of arthritis that occurs in the knee joint. It most commonly affects those aged 50 and over, though it can also occur in younger patients too.
The condition causes a number of symptoms which worsen over time. The most common symptoms include:

  • Pain
  • Swelling
  • Locking of the joint
  • Limited range of motion
  • Cracking or popping sounds

The condition develops due to a loss of cartilage between the joint. This causes the bones to rub together, causing unpleasant symptoms. Many patients end up requiring a knee replacement, though some may be treated using non-surgical methods.

Best exercises to avoid making knee arthritis worse

Overweight patients are advised to lose weight in order to help ease the symptoms of knee OA. However, as the recent study shows, some types of exercise can prove damaging to the joint. So, which exercises should you be focusing on if you’re looking to lose weight and protect the joint?

Ideally, you will want to focus on low-impact, gentle exercise to start with. This includes walking or jogging, alongside knee strengthening exercises. If you do still want to enjoy racket sports, you can switch to lower impact sports such as badminton.

Overall, this new study highlights the risks racket sports pose to overweight patients. Therefore, when looking to reduce weight prior to a knee replacement, lower impact sports are recommended.

When to Return to Play: Predicting When Your ACL Graft Has Healed

ACL graft recovery

One of the most common questions athletes have after undergoing an ACL graft, is when they can return to play. Like any surgery, it is important for patients to rest and recover until they are fully healed. Returning too soon to sport increases the risk of the need for repeat surgery, graft rupture and knee osteoarthritis.

So, how can you tell when it is the right time to return to play? Here, we’ll look at how to predict when your ACL graft has healed.

MRI imaging can be a good indicator

One of the main way’s physicians determine how well an ACL graft is healing, is through MRI imaging. While this can’t necessarily determine the strength of the joint, it can be used as a good baseline.

Studies have shown that ACL grafts follow a predictive pattern of healing over a 12-month period. However, these studies have been quite small so further research would prove useful to determine a more precise picture.

Factors that affect ACL graft recovery

There are a number of factors which can affect ACL graft recovery. These include:

  • Strength and flexibility
  • Age
  • Graft choice
  • Aftercare

The strength and flexibility of the joint will ultimately impact how quickly a patient heals from an ACL graft. The stronger and more flexible the joint, the quicker patients will recover. This is why physical therapy is provided after the surgery. By strengthening up the joint, it will reduce recovery time and see athletes returning to play much quicker.

Age is also a factor, with older patients typically finding it takes longer to recover. The choice of graft could impact recovery. There are several types of ACL graft procedures that can be carried out. Experts claim more research needs to be undertaken to determine how the different types of graft impact recovery.

Finally, aftercare is another factor to consider. It is really important for patients to follow aftercare instructions provided by the surgeon. This aids in the healing process, ensuring best results are experienced.

How long does it usually take to return to sport?

On average, just over half of patients return to a competitive level of sport within 1-2 years. Approximately 80% of those who have undergone ACL reconstruction return to some level of sport, so the statistics are quite good. Many patients start returning to play within six months, although this will differ depending on a variety of factors.

It is difficult to give an accurate picture of how long the recovery process will take. While MRI imaging can be provided to give an indication of healing, it doesn’t provide an exact timeframe for recovery.

The best way for patients to get back to the sport they love, is to follow the guidelines given to them by their surgeon. Studies have shown going back to sport too early increases the risk of re-injury. This would result in a greater amount of time off and potentially end your career. So, taking enough time to heal is essential for those looking to return to play.

For more advice on ACL graft recovery, call 08450 60 44 99 to arrange a consultation with Mr Jonathan Webb at his Bristol knee clinic.

Protecting Your Knee Replacement in Younger Patients

protecting knee replacement in younger patients

Knee replacements are typically associated with an older patient demographic. However, with each passing year, there is a growing number of younger patients undergoing the procedure. In fact, experts predict that by 2030, there will be a 183% increase in the number of knee replacements carried out on patients 65 and younger.

Now, research has shown that younger knee replacement patients are more likely to require a revision surgery. A number of lifestyle factors are thought to contribute towards a high revision surgery rate. So, how can younger patients protect their knee replacement and avoid a second surgery?

Here, we’ll look at what the new study revealed and how young patients can better protect their knee replacement.

Study shows lifestyle factors could increase knee replacement risk

The latest study carried out by the Missouri School of Medicine in the US, looked to identify the revision rate of knee replacement surgeries in younger patients. A medical record review of 147 patients was carried out and compared against 276 patients aged from 65-75. They reported on reoperation rates, patient demographics, reoperation complications and chronic conditions.

It was revealed that younger patients were twice as likely to require a revision surgery within two years of the initial procedure. They were also found to have an increase rate of revision surgery complications.

There are a number of reasons why the increased revision rate might occur in younger patients. However, the study found that tobacco use and other lifestyle factors play a leading role. Many studies have found that smoking can drastically impact the body’s ability to heal after surgery. Other lifestyle factors thought to increase the risks include obesity and low levels of daily activity.

The majority of knee replacements can last over 25 years

Recently, researchers have discovered that the majority of knee replacements last over 25 years. Data taken from a number of National Registries shows that around 82% of total knee replacements can last for more than two decades. However, most patients included in this study had an average age of 69.

Knee replacement risks higher in male patients

An interesting finding is that men tend to have a higher risk of complications than women. This is despite the fact that women tend to undergo more joint replacement surgeries than men. In 2013, a study showed that men had a 31% increased risk of wound infection and a 20% increased risk of revision surgeries than women.

Understanding the risks and complications is important for both patients and clinicians. The increased risks discovered in younger patients highlights the need for the right level of aftercare. By understanding the risks, patients can make adjustments to their lifestyle to improve the chances they won’t need a revision surgery later on. It also shows non-operative treatments might be the best option to delay or avoid surgery.

To arrange a consultation at our Bristol clinic, call 08450 60 44 99. To arrange a consultation at our London clinic, call 0203 195 2443.

Is Your Job a Pain in the Knee? Study Reviews Link Between Your Occupation and Knee OA

knee OA and your job

New research has linked a person’s occupation and an increased risk of developing knee OA or osteoarthritis.

In the largest study of its kind, researchers from the UK and Australia wanted to determine whether the job you do impacts your risk of developing osteoarthritis in the knee. The goal was to identify occupations which may carry a higher risk, and better understand how workplace exposure links to knee OA.

Here, we’ll look at what the researchers found and how occupation can affect your risk factor of developing this painful condition.

Understanding the study

The latest study was carried out by researchers from Oxford, Southampton and Sydney universities. They looked at data from the UK and the US in the largest observational study of its kind. It revealed that an increasing workload was associated with a higher risk of knee OA, particularly for men.

Compared to sedentary workers, men were found to be two times more likely to suffer with knee OA. In contrast, there were no patterns associated with women. Researchers suggest this is because men often carry out more physical work, even when they have the same job as women.

This study included a broad range of occupations, including light and moderate workloads. Interestingly, it suggested that a light workload could protect workers from requiring a total knee replacement. In conclusion, a link was identified between a heavy workload and the risk of knee OA.

Which jobs pose the biggest threat?

The findings of the study, published in the Arthritis Care and Research journal, revealed the riskiest jobs in terms of knee OA. It was discovered that construction and agricultural workers, miners, houseworkers and service workers were the most likely to develop the condition.

Understanding the occupations which pose the biggest threat is crucial in the fight to prevent knee OA. Workers within these industries can take appropriate measures to reduce their risk.

What is knee OA?

Knee OA is short for knee osteoarthritis. It is also known as degenerative joint disease and it most commonly affects older men and women due to wear and tear. There are two types of the condition, known as primary and secondary.

It is estimated that by 2050, around 130 million people will suffer with some form of osteoarthritis. Earlier this month, we marked World Arthritis Day, helping to spread awareness of this debilitating condition. It is thought that the rate of osteoarthritis has increased by more than 50% over the past 15 years.

The most common symptom of knee OA is pain. Stiffness, tenderness, swelling and loss of flexibility are also common signs of the condition. It is becoming an increasing concern in the workplace, causing thousands of workers to take time off due to the condition.

This new study reveals an interesting link between certain occupations and the prevalence of knee OA. Those working in high-risk sectors should take measures to protect their knees in order to prevent the condition from developing. For more advice on managing knee OA, call 08450 60 44 99.

ACL Tears Can Do Real Damage to the Brain, Study Finds

ACL tears

Trauma to the anterior cruciate ligament, or ACL, has been found to also do real damage to the brain in a new study. It is already known that ACL tears can lead to some degree of permanent loss of joint function. However, the reason behind this isn’t clear.

The new study, published in NeuroImage: Clinical, was carried out by researchers at the University of Michigan. Here, we’ll look at what the new study found and how ACL injuries link to brain damage.

Latest ACL injury study

The latest study involved 10 patients who had undergone ACL reconstructive surgery. MRI brain scans were taken to assess brain activity.

The scans clearly showed areas of the corticospinal tract had experienced deterioration. This is the part of the brain responsible for relaying messages to the muscles. On average, the side of the corticospinal tract which correlated to the knee which received ACL reconstruction, was around 15% smaller than the other side.

As the pathway is smaller, it means less information can be passed onto the muscles from the brain. What this means for patients, is that there is a chance of re-injury, as well as issues with performance and a potentially slower recovery. It also means, even with physiotherapy, joint function might not return to normal.

The link between ACL tears and brain damage

This new small study isn’t the only one to look at brain damage caused by ACL reconstruction. A previous study, published in the Journal of Orthopaedics & Sports Physical Therapy, showed a lag in parts of the brain during recovery from ACL surgery.

The study revealed that those recovering from ACL surgery, relied on visual systems within the brain, rather than instinct when moving the knee. Confidence in using the knee reduced significantly, making it especially tough for those partaking in sports. In a bid to reduce the issue, therapists in Ohio are using strobe glasses to visually distract patients, forcing their brains to rewire back to their original state.

Researchers from the most recent study, believe the changes in the brain are as a result of a defence mechanism. They think the brain tries to reduce movement around the joint injury to aid its recovery. However, this is just a theory. What is known for sure, is ACL surgery doesn’t just affect the way the brain communicates with the body, but it also changes the brains building blocks too.

Even with the research that has been carried out so far, it is still unsure why ACL reconstructive surgery damages the brain. However, the research does provide more guidance on how patients should be treated.

Rather than just focusing on improving the range of movement in the joint and reducing swelling, a systematic review of treatments needs to be considered. Approaches such as re-wiring the brain for example, could work well to help the body adapt.

Overall, ACL injuries can have a significant impact on a patient’s life, particularly for those who partake in sports. This new research shows the damage that can occur and how it should potentially be treated.