Permanent knee sensorimotor system changes following ACL injury and surgery

Area of Science:

• Orthopedics
• Sports Medicine
• Neuroscience

Background:

• Anterior cruciate ligament (ACL) reconstruction is standard, but ACL repair is being reconsidered.
• Advances in scaffolding, suturing, and biologics (PRP, stem cells) support ACL repair.
• Preserving native ACL structures offers potential benefits over reconstruction.

Purpose of the Study:

• To review the neurosensory and biomechanical functions of the knee's capsuloligamentous system, focusing on the ACL.
• To discuss the potential of ACL repair to preserve native tissues and improve functional recovery.
• To explore innovative rehabilitation and outcome measurement strategies for ACL interventions.

Main Methods:

• Review of current literature on cruciate ligament anatomy, function, and surgical techniques.
• Discussion of neurosensory pathways, including peripheral and central nerve involvement.
• Analysis of evidence supporting ACL repair versus reconstruction.

Main Results:

• ACL repair may preserve native neurosensory systems, entheses, and ACL footprints.
• Preservation of tissues can enhance recovery of neuromuscular control and dynamic knee stability.
• Potential for improved return-to-sport rates and addressing osteoarthritis.

Conclusions:

• ACL repair is a viable alternative to reconstruction, offering potential benefits for neurosensory preservation and functional recovery.
• Further research and innovative strategies are needed to optimize ACL repair outcomes.
• A holistic approach considering biomechanics, neurosensory function, and psychobehavioral factors is crucial for evaluating interventions.