Many of us are familiar with the pains of a torn ligament. One of the worst ligaments you can tear is the anterior cruciate ligament (ACL), which lies under the kneecap and connects the thigh and shin bones. The ACL is notoriously difficult to heal, as it tends to unravel when torn; athletes with this injury have months of difficult recovery ahead of them, and usually have to take parts from other ligaments for the ACL to return to full strength.
This scenario may be about to change. A research team led by Dr. Cato Laurencin, chair of UVA’s Department of Orthopaedic Surgery, has created synthetic scaffolds for the ACL that speed healing time and increase the strength of the regenerated ligament. The scaffolds, made of a biodegradable polyester called polylactide, naturally dissolve in the body over time.
In a study published in the Proceedings of the National Academy of Sciences, researchers replaced the ACL ligaments of rabbits with the scaffolds and charted ACL regeneration over a 12-week period. The rabbits were able to put weight on their knee joints within just 24 hours of the surgery, and subsequent ACL regeneration was faster than expected. Most significantly, the study demonstrated that it was possible for this ligament to heal without using ligaments from cadavers or other areas of the body.
Despite these promising results, the researchers pointed out the need for more long-term studies to chart the extended progress of the scaffolded ACL regeneration process, and to determine how long it would take for the ligament to return to full strength. Of course, just because the scaffolds work well in rabbits doesn’t mean they will necessarily work as well in humans.
Nevertheless, Laurencin is optimistic that further research will eventually lead to effective interventions for humans. “It is my hope that these studies will lead to a revolutionary new treatment strategy for patients suffering from ACL tears,” he says. If Laurencin’s team is successful, then a torn ACL won’t be the athletic catastrophe it once was.