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"This innovative technique more accurately recreates an ACL's normalanatomy," explains Dr. John Samani, M.D. "We believe this procedure alsostabilizes the knee to a degree never seen before with traditional ACLreconstruction."
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Samani, and his partner, Dr. Thomas Perkins, D.O., successfully beganperforming anatomic double-bundle ACL reconstruction earlier this year throughtheir Michigan Knee and Shoulder Institute in Auburn Hills after returningfrom an international symposium led by top surgeons from around the world whoregularly perform the double-bundle procedure.
The normal ACL is composed of two bundles that perform distinct functionsto control knee stability and rotation. The double-bundle procedurereconstructs both bundles in the ACL. The traditional approach reconstructsonly the injured bundle.
The double-bundle procedure has been used in Europe for nearly a decadeand has been under study in the United States since 2002. Samani and Perkinswere two of only a handful of physicians from the Midwest to attend thesymposium and then utilize the technique at their sports-medicine practicehere in metro Detroit.
ACL tears, among the most common sports-related knee injuries for bothmales and females, happen when the ACL is stretched beyond the normalelasticity range. More than 200,000 ACL tears occur each year in the UnitedStates. The highest incidence is in individuals between 15 and 25 years oldwho participate in pivoting sports, such as soccer and football. Injuries alsooccur with significant frequency in middle-aged athletes. They have reachedalmost epidemic proportions in young female athletes, adds Samani.
The vast majority of orthopedic surgeons in the country currently use asurgical technique that reconstructs only one of the ACL's two anatomicbundles - even though an injury to the knee disrupts both bundles, causing acomplex ACL instability. Recent studies suggest that the single-bundletechnique inadequately controls this instability, so those undergoing thesingle-bundle surgery complain the knee never feels as stable as it did beforethe injury and reconstruction.
Even more crucial, about 90 percent of athletes who undergo traditionalsingle-bundle ACL surgery develop significant arthritic changes in the kneewithin 10 years.
In contrast, the double-bundle surgery restores both ligaments to theiroriginal anatomic structures, allowing each ligament to better perform itsunique function in giving the knee forward movement and rotational stability.
"Double-bundle reconstruction is like a custom rebuild, more closelyrestoring the patient's ACL to the way it was before the injury," explainsPerkins. "By doing so, we are optimistic we can give athletes a knee thatfeels more like it did before the injury while hopefully preventing thedevastating consequence of arthritis down the road."
Samani and Perkins agree that doing everything possible to stop futurearthritis is key. They have performed the double-bundle reconstruction on maleand female patients ranging in age from 15 to 45.
The two board-certified orthopedists say they were driven to research moreeffective ACL surgery techniques after spending years working with college andprofessional athletes who repeatedly suffered increased post-surgicalarthritis rates.
Samani, who worked with three Minnesota pro teams - the Twins, the Vikingsand the Timberwolves - while on a sports-medicine fellowship at the Universityof Minnesota's Sports Medicine Center, is orthopedic consultant for the Twinswhen they play in Detroit. Perkins worked with Michigan State Universityvarsity athletes while training in East Lansing and remains an MSU athleticconsul
