Structure and Function Are Not the Same: The Case for Restoring Mechanoreceptor Continuity Following Anterior Cruciate Ligament Injury

Authors

Jillian E Beveridge
Payam Zandiyeh
Brett D Owens
Ata M Kiapour
Braden C Fleming

Publication Date

8-1-2024

Journal

Rhode Island Medical Journal

Abstract

Anterior cruciate ligament (ACL) injury, particularly in increasingly young and active adolescents, continues to pose a clinical challenge with re-injury rates reported as high as 30%. Evidence also suggests that current standard-of-care ACL reconstruction (ACLR) does not mitigate post-traumatic osteoarthritis (PTOA) risk. Bridge- enhanced ACL restoration (BEAR) is a recently developed and tested ACL surgery that promotes primary healing of the native ACL with excellent early results. BEAR has shown to reduce signs of early PTOA compared to ACLR in an animal model. Here, we describe a theoretical framework related to re-innervation that can clarify why the outcomes of ACLR and BEAR surgeries differ. We also discuss how ongoing and new challenges in determining return-to-sport readiness following the competing surgeries may differ, and how emerging imaging tools and measures of neuromuscular function may aid in clinical decision-making to decrease the likelihood of re-injury and PTOA risk.

Keywords

Animals, Humans, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Mechanoreceptors, Osteoarthritis, Knee, Return to Sport, ACL, kinematics, neuromuscular, post-traumatic osteoarthritis, surgery

PMID

39058984

PMCID

PMC11609849

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes