Can ACLs heal and what is the latest evidence-based management with Dr Steph Filbay

On this episode I was joined by Dr Stephanie Filbay to discuss all things ACL rupture.

Dr Stephanie Filbay is a physiotherapist, and Senior Research Fellow at Univeristy of Melbourne and is a leading researcher in knee ACL managment including emerging research on ACL healing. 

The following is an outline of our chat.

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QUICK FIRE QUESTIONS 

1. Do early ACL reconstructions lead to better patient outcomes?

2. Are ACL reconstructions necessary to return to sport?

3. Do ACL reconstructions prevent further knee damage?

4. Do ACL reconstructions reduce the chances of osteoarthritis?

5. Are there currently too many ACL reconstructions performed? 

6. Can ACLs heal?

 

Cross bracing protocol 

• What is the cross bracing protocol including rationale for it?

• Study and results.

• Shortcomings of this study and what future research do we need?

• What are the implications of this research?

 

Decision making aid 

Decision making aid for patients and clinicians in light of this new research.

• What are the consequences of ACL rupture?

• What are the objectives of management - 

• Restore knee function

• Address psychological barriers 

• Prevent further injury and reduce risk of OA

• Optimise long term Quality of Life

• What management options do people who have just torn their ACL have? 

• Do outcomes differ depending on what management approach is chosen?

• Knee laxity and functional instability 

• Return to sport

• Does early surgery prevent additional meniscus and cartilage damage - what does the evidence we have say about this belief?

• Preventing further knee damage and long term OA

• Discussing management options and expectations for someone who has just torn their ACL - Steph what do you wish someone had told you when you first tore your ACL? 

• Eg all patients of 181 expected to have normal knee function after ACLR and 91% expected to return to sport - is this realistic? 

• Are there any practical steps that people can take after injury if they want to consider participating in the Cross Bracing Protocol?  

• Are there any less extreme options open for people who want to help their chances of healing but don’t want to have their knee in a brace for 12 weeks? 

You can find Steph on Twitter (@stephfilbay).