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Anterior Cruciate Ligament (ACL) Tear
Tears of the anterior cruciate ligament (ACL) are common injuries in young athletes. These can occur from contact or noncontact mechanisms and from various sporting activities. While nonoperative treatment can be considered, active patients are usually offered ACL reconstruction in order to allow for return to cutting sports, as well as help protect against meniscus and cartilage injury. Dr. Owens performs all types of reconstruction techniques using all available graft options – customized to the specific needs and desires of each patient. He is a member of the Multicenter ACL Revision Study (MARS) Group – a collection of some of the busiest revision ACL surgeons in the nation.
TIBIAL EMINENCE FRACTURES IN ADOLESCENTS ARE ACL AVULSIONS
In a skeletally immature patient, the ACL can fail by pulling off a piece of bone on the tibial side instead of tearing in its mid-substance. These tibial eminence fractures are treated with arthroscopic suture and/or screw repair techniques.
ACL TEARS ARE ENDEMIC IN THE MILITARY POPULATION
This epidemiologic analysis of the active duty military population found incidence rates that were 10 times greater than civilian reports. Other findings included young age and male gender as risk factors for injury.
COOLING AND COMPRESSION THERAPY IMPROVES PAIN CONTROL FOLLOWING ACL RECONSTRUCTION
Randomized controlled trial of combined cooling/compression use versus traditional ice packet application resulted in decreased narcotic use and significant pain improvement following ACL reconstruction.
ALLOGRAFT ACL RECONSTRUCTION IN YOUNG ATHLETES HAS HIGH FAILURE RATE
Review of incoming USMA cadets whom had previously undergone ACL reconstruction showed a significantly higher failure rate among those receiving allografts compared with autograft surgeries.
MILITARY MOVEMENT COURSE CHANGES JUMP LANDING MECHANICS
Military course teaching body control helped improve landing mechanics associated with ACL injury in this prospective study of West Point cadets.
ACL INJURY RESULTS IN CHANGES IN CARTILAGE BIOMARKERS
This study of ACL injured patients involved testing pre- and post-injury markers for cartilage production and breakdown and found significant changes over time compared with control patients.
USE OF POST-RECONSTRUCTION BRACE FOR ACL PATIENTS IS DEBATED
The current data on the use of postoperative braces in ACL patients is reviewed. Current data does not support routine use but patient and surgeon preference is critical to decision making.
AUTOGRAFT ACL REVISION RECONSTRUCTION HAS BETTER OUTCOMES
MARS group paper analyzed subjective outcome of large cohort of ACL revision patients. Autograft use resulted in improved subjective outcome scores, improved sports function, and lower repeat rupture rates.
MULITPLY REVISED ACL PATIENTS HAVE MORE DEGENERATIVE CHANGES IN KNEE
MARS group study compared patients undergoing a multiple revision reconstruction of ACL and patients undergoing their first ACL revision. They found significantly more meniscal and cartilage lesions in the multiply revised group as well as lower activity levels.
SMALLER BONE BLOCKS MAY BE USED FOR BTB AUTOGRAFTS
This study performed mechanical testing of patella tendon grafts in a porcine model. Difference sizes of bone plug were compared and no differences were found – suggesting that a smaller bone plug may not result in increased failure of the fixation construct.
MULTIPLE RADIOGRAPHIC FINDINGS AT REVISION ACL RECONSTRUCTION
MARS group study reports on the radiographic findings noted at time of ACL revision reconstruction in the largest known study of ACL revision patients.
FEMORAL TUNNEL MALPOSITION SEEN AT ACL REVISION
MARS group study reports that femoral tunnel malposition was cited in half of ACL revision cases and was judged to be the principle technical cause of failure in one quarter of cases.
MODERN PUMP DESIGN RESULTS IN SHORTER TIME FOR ACL RECONSTRUCTION
The use of a pressure and flow control pump improved visualization and decreased operative time for ACL reconstruction compared with a pressure control only model.
AREAS OF EXPERTISE
PRESS & PUBLICATIONS
Anterior Cruciate Ligament (ACL) Tear
Medial Collateral Ligament (MCL) Tear
Posterior Cruciate Ligament (PCL) Tear
Posterolateral Corner (PLC) Injury
Multiligamentous Knee Injury/
Dr. Brett D. Owens
100 Butler Drive
Providence, RI 02906
All information contained on the BrettOwensmd.com website is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.