ACL Reconstruction, Past, Present, and Future | The Sports Medicine Research Rundown - Ep. 1

Episode 1 - ACL Reconstruction: Past, Present and Future
In this inaugural episode, Dr. Stephen Nicholas from The Nicholas Institute of Sports Medicine and Athletic Trauma joins host Tim Tyler to provide a comprehensive overview of anterior cruciate ligament (ACL) reconstruction surgery.
Dr. Nicholas shares his unique perspective as the son of pioneering orthopedic surgeon Dr. James A. Nicholas, walking through the evolution of ACL procedures from the extra-articular techniques of the past to today's anatomic, arthroscopic reconstructions using autografts like bone-tendon-bone and hamstring tendons.
#physicaltherapy #knee #acl #podcast #nismatyt
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*CHAPTERS*
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[00:04] Introduction to the podcast
o Hosted by Tim Tyler
o Focus on surgery and pathology history, current, and future
o Monthly episodes with surgeon guests
[01:37] Dr. Stephen Nicholas’ background
o Extensive experience in sports medicine
o Director of the Nicholas Institute of Sports Medicine
o Discusses ACL reconstruction evolution
[07:00] Current ACL reconstruction techniques
o Various graft options: hamstring, quadriceps, patellar tendon
o Importance of early fixation and load to failure
o Comparisons of graft strengths and surgical outcomes
[11:14] Prehabilitation and post-surgery recovery
o Emphasis on achieving full extension before surgery
o Importance of psychological preparation
o Recovery techniques and weightbearing protocols
[17:34] Use of allografts and autografts
o Autografts preferred for younger, active individuals
o Allografts used sparingly, mainly in low-demand athletes
o Discussion on graft choices for revision surgeries
[25:07] Future of ACL reconstruction
o Potential use of stem cells and biologics
o Genetic engineering advancements
o Growing personalized ligaments for reconstruction
[26:49] Graft Choices and Rehabilitation
o Discusses meniscal repair and rehabilitation protocols
o Explores non-surgical approaches for non-copers
o Emphasizes the importance of tailored rehabilitation
[32:01] Surgical Techniques and Outcomes
o Examines different surgical techniques and their outcomes
o Analyzes the success rates of various graft types
o Considers the long-term effects on athletes’ performance
[37:00] Postoperative Care and Return to Play
o Highlights the critical period for graft vulnerability
o Discusses the role of postoperative bracing
o Addresses the psychological aspects of returning to sports
[44:00] Comparative Study of Graft Types
o Reviews a study comparing hamstring and quadriceps tendon grafts
o Discusses the implications of graft choice on strength and recovery
o Highlights the importance of consistent rehabilitation programs
[53:46] Study on return to play
o High incidence of athletes not returning to previous levels
o Factors like talent and graduation affecting return rates
o Importance of considering non-surgical reasons
[54:49] Surgical techniques and outcomes
o Lateral knee pain from ITB lateral sling reinforcement
o Changes in surgical and rehab practices over time
o Impact of extra-articular reconstruction and casting
[55:26] Rehabilitation and patellofemoral pain
o Study showing reduced patellofemoral pain with full weightbearing
o Hip flexion weakness correction leading to symptom resolution
o Importance of rehab intervention for patellofemoral joint after ACL reconstruction
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*These Videos are provided for informational and educational purposes only and should not be used as a replacement for appropriate medical treatment. Please consult your doctor or licensed physical therapist for an appropriate course of treatment*