New HSS Study To Tackle Critical ACL, UCL Failure Issue

Orthopedics This Week—October 21, 2014

"Failure," says a savvy surgeon, "is the dirty underwear drawer of orthopedic surgeons." David Altchek, M.D. is an attending orthopedic surgeon and co-chief in the Sports Medicine and Shoulder Service at Hospital for Special Surgery (HSS). Dr. Altchek tells OTW, “In both the anterior cruciate ligament (ACL) of the knee and the ulnar collateral ligament (UCL) of the elbow we now have solid techniques and we are getting good outcomes.

So now, we are getting greedy—appropriately so—and we want 'no' failures. We are doing MRIs postop to look at reconstructing ligaments in both the UCL of the elbow and the ACL of the knee. We need to determine when the ligament starts to mature and when we can start loading it. Perhaps some people are returning to pivoting and throwing before they are ready."

"In this study, which involves five HSS surgeons, we are aiming for 200 ACLs and 100 UCLs. We hypothesize that some people heal slower and therefore the ligament doesn't mature as fast. By taking MRIs a month postop, then at three months, seven months, and one year, we will have a solid idea of what these ligaments look like in periods of healing. We will be able to pinpoint the junctures at which they change and mature."

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