The Next Breakthrough in ACL Rehabilitation

The durability of ACL repair surgery was first questioned in 1976. Since, ACL reconstruction has become the gold standard treatment for ACL rupture.

Over the past 50 years, rehabilitation clinicians and researchers alike have committed significant resources to optimizing care of individuals throughout their recovery. Such efforts are necessarily distributed across the biopsychosocial and ICF models with emphasis on everything from therapies for specific impairment, impacts and considerations of psychosocial factors, to re-integration into unrestricted life and sport participation. 

Unfortunately, as in all healthcare practice, there remains a large gap between emerging research findings and clinical translation.

Contrast this with the “scientific breakthrough”.

Breakthroughs (i.e., sudden discoveries with major impacts) are preempted by development of new instruments and technology that make new features of the problem visible. 

In classic example, the invention of the telescope led to Galileo’s discovery of a sun-centered solar system (circa 1610).

From one invention, came The Universe.

More recently, the development of CT, MRI, and PET scans in the 1970s gave medical practitioners three unique perspectives on human tissues that have vastly changed the medical landscape. 

Unfortunately, breakthroughs are hard to define in orthopedic rehabilitation. Instead, changes in clinical practice guidelines over time reveal slow progress in clinical translation, continued shortfalls in clinical outcomes, diminishing returns in once promising avenues of research, and notably absence of new technology and innovations.

How can we optimize for breakthroughs in ACL injury? What new technology will revolutionize our practice?