Welcome to ‘On the Table’ – UPMC Sports Surgery Clinic’s orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.
The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.
In Episode Eight, we are delighted to speak to Mr Ray Moran, Consultant Orthopaedic Surgeon and Medical Director at UPMC Sports Surgery Clinic.
This episode focuses on the topic of decision making around the Anterior Cruciate Ligament (ACL), the evolving techniques into ACL graft selection and the rehabilitation and post-operative management and Ray’s latest paper on ACL outcomes.
What is an ACL ligament?
Can you talk me through the decision making regarding surgical repair with the patient?
What about the debate on conservative non-operative management of ACL rupture?
How important is a timeline for the patient?
The outcome of your recent paper in AJSM shows a very low re-injury rate in a big series?
What are the critical time points postoperatively in management?
The paper showed that bone patellar bone was prefered for a lower re-injury rate, but the Hamstring graft did ok, too, what makes that decision?
There is always a new version of the operation, the Australians suggested using Kangaroo tail, we went through a phase of LARS repair, and the follow up suggested these really were not that good, but they are reappearing and now the Quad tendon repair – why the continual quest to change?
Bertrand Sonnery-Cottet from Lyon has published some work on assisted ligament repair of proximal ACL’s is this something that might come to SSC in the future?
How important is graft tension to a successful outcome?
Biomechanical analysis has led to a low re-injury rate, how important is this and if re-injury does occur what then?
Papers mentioned in the podcast
Factors Influencing Return to Play and Second Anterior Cruciate LigamentInjury Rates in Level 1 Athletes After Primary Anterior Cruciate LigamentReconstruction: 2-Year Follow-up on 1432 Reconstructions at a Single Center.
King E, Richter C, Jackson M, Franklyn-Miller A, Falvey E, Myer GD, Strike S, Withers D, Moran R.Am J Sports Med. 2020 Mar;48(4):812-824.
ACL or ACL.
Reider B.Am J Sports Med. 2020 Feb;48(2):281-284.
ACL rupture in the immediate build-up to the Olympic Games: return to elite alpine ski competition 5 months after injury and ACL repair.
Praz C, Kandhari VK, Saithna A, Sonnery-Cottet B.BMJ Case Rep. 2019 Mar 15;12(3):e227735.
About Mr Moran