Patients With ACL Tears Now Have a Non-Surgical Option with a Faster Recovery
Is it necessary to get surgery for a torn ACL? A clinical study on patients with ACL tears shows that bone marrow concentrate (BMC) procedures are a promising alternative. The ideal patient for a BMC procedure is a patient with a grade one, two, or mild grade three ACL tear, who would slightly alter their lifestyle to accommodate their injured knee. While a college football player with a severe grade three ACL tear might require surgery, a similar athlete with a lesser grade 3, grade 2 or grade 1 ACL tear might be able to avoid surgery altogether.
What is an ACL Tear?
The anterior cruciate ligament (ACL) is located in the knee and connects the femur to the tibia (1). It is possible for this piece of connective tissue to strain or tear, especially during quick-paced sports that require sudden movements and changes in direction of movement.
There are different levels, or “grades” of ACL tears, ascending in number and severity. A grade one ACL tear means that the ligament has been over-stretched, a grade two indicates a stretched and partially torn ligament, and in a grade three ACL tear, the ACL is entirely torn in two parts (1).
ACL Tears in the US
A torn ACL is a quite common injury in the United States, with an estimated number of 100,000-200,000 incidents occurring annually (1). An ACL tear is a non-contact injury that can happen to any person of any age, but due to the nature of the injury (often a sharp, sudden movement) ACL tears are common in young athletes. However, this does not mean that active older adults are exempt from the injury. The question that remains is what type of treatment is suitable for which type of ACL tear. (6)
A bone marrow concentrate (BMC) procedure is a non-surgical procedure in which a bone marrow sample is extracted from a patient and then re-injected into the patient’s injured area in order to help improve the healing of a wound or injury (8). Bone marrow contains stem cells, which are “undifferentiated” cells that are held in reserve and can become a different type of tissue (8). These stem cells are the main portion of the BMC that has a maximum regenerative effect. When the bone marrow concentrate is re-injected into the patient’s body, the stem cells can create new tissue and help repair damaged tissues, such as a torn ACL (8).
Clinical Study – BMC for ACL Tears
A study published in 2018 in the Journal of Translational Medicine found BMC treatment to be promising for patients suffering from ACL tears (5). The study was open to patients above the age of fifteen with ACL tears ranging from grade one, two, and even three, providing that the patients with grade three tears had <1 cm of retraction (the pieces of the ripped ligament pulling away from each other) (5). Grade three ACL tears with retraction >1 cm are very severe and would likely require surgery to heal (7).
Ultimately 29 patients ranging from ages 15 to 65 with ACL tears received BMC injections consisting of bone marrow aspirate that was extracted from the patient’s own body on the same day of the procedure (5). Here is a summary of their results:
- 23 of the 29 patients had grades two and three ACL tears; ultimately only five decided to undergo surgery, and only one patient who did not receive surgery suffered a re-tear (once they returned to sports) (5).
- Mean last-reported SANE scores* were as follows:
- 93% improvement among 6 Grade 1 ACL Tear patients
- 74% improvement among 13 Grade 2 ACL Tear patients
- 69% improvement among 10 Grade 3 ACL Tear patients
*Single Assessment Numeric Evaluation, SANE, asks patients to assign what percentage difference have you seen in your condition, compared to your condition before the procedure.
Overall, the improvement in pain and function and low re-tear rate for the patients who received BMC treatment for ACL tears shows a promising non-surgical treatment option for those suffering from a torn ACL (5).
Recovery Time, BMC vs. Surgery for ACL
Recovery after surgery for an ACL tear is a long process – the patient can’t move much in the first one to two weeks post-surgery, and they’ll have to walk on crutches until about 2-3 weeks after surgery (9). In weeks 6-24 of recovery, the patient will have to gradually return to more active activities as they and their doctor see fit (9).
In the clinical study examining BMC treatment for ACL tears, the MRI images taken of patients’ knees showed a gradual healing progression from the time of the treatment up to 11 months after the initial treatment (5). The pain rating scores which patients ascribed to their pain showed improvement even at one and three months after treatment. Patients continued to improve from 3-36 months post-treatment (5).
ACL Patient Outcomes Among All US Regenexx Patients
Regenexx keeps a database of procedure outcomes from all of its member clinics. Patients who receive the Regenexx-SD bone marrow concentrate procedure for ACL tears report that their overall joint function improves drastically in the first 6 months after treatment (10). After that, the positive progress continues more gradually up to three years after the treatment (10).
To find out if you’re a candidate for the Regenexx Perc ACL-R SD BMC procedure–Tap the “TALK TO AN EXPERT” BUTTON below.