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Two Michigan Orthopedic Surgeons Pioneer Innovative ACL Surgery with New Benefits for Athletes, Weekend Warriors
Date:4/22/2008

Procedure adds stability, may abolish post-operative arthritic knee pain

AUBURN HILLS, Mich., April 22 /PRNewswire-FirstCall/ -- A new, more effective surgery to repair a common sports-related knee injury, the torn ACL (anterior cruciate ligament), is now available in Michigan.

"This innovative technique more accurately recreates an ACL's normal anatomy," explains Dr. John Samani, M.D. "We believe this procedure also stabilizes the knee to a degree never seen before with traditional ACL reconstruction."

Samani, and his partner, Dr. Thomas Perkins, D.O., successfully began performing anatomic double-bundle ACL reconstruction earlier this year through their Michigan Knee and Shoulder Institute in Auburn Hills after returning from an international symposium led by top surgeons from around the world who regularly perform the double-bundle procedure.

The normal ACL is composed of two bundles that perform distinct functions to control knee stability and rotation. The double-bundle procedure reconstructs both bundles in the ACL. The traditional approach reconstructs only the injured bundle.

The double-bundle procedure has been used in Europe for nearly a decade and has been under study in the United States since 2002. Samani and Perkins were two of only a handful of physicians from the Midwest to attend the symposium and then utilize the technique at their sports-medicine practice here in metro Detroit.

ACL tears, among the most common sports-related knee injuries for both males and females, happen when the ACL is stretched beyond the normal elasticity range. More than 200,000 ACL tears occur each year in the United States. The highest incidence is in individuals between 15 and 25 years old who participate in pivoting sports, such as soccer and football. Injuries also occur with significant frequency in middle-aged athletes. They have reached almost epidemic proportions in young female athletes, adds Samani.

The vast majority of orthopedic surgeons in the country currently use a surgical technique that reconstructs only one of the ACL's two anatomic bundles - even though an injury to the knee disrupts both bundles, causing a complex ACL instability. Recent studies suggest that the single-bundle technique inadequately controls this instability, so those undergoing the single-bundle surgery complain the knee never feels as stable as it did before the injury and reconstruction.

Even more crucial, about 90 percent of athletes who undergo traditional single-bundle ACL surgery develop significant arthritic changes in the knee within 10 years.

In contrast, the double-bundle surgery restores both ligaments to their original anatomic structures, allowing each ligament to better perform its unique function in giving the knee forward movement and rotational stability.

"Double-bundle reconstruction is like a custom rebuild, more closely restoring the patient's ACL to the way it was before the injury," explains Perkins. "By doing so, we are optimistic we can give athletes a knee that feels more like it did before the injury while hopefully preventing the devastating consequence of arthritis down the road."

Samani and Perkins agree that doing everything possible to stop future arthritis is key. They have performed the double-bundle reconstruction on male and female patients ranging in age from 15 to 45.

The two board-certified orthopedists say they were driven to research more effective ACL surgery techniques after spending years working with college and professional athletes who repeatedly suffered increased post-surgical arthritis rates.

Samani, who worked with three Minnesota pro teams - the Twins, the Vikings and the Timberwolves - while on a sports-medicine fellowship at the University of Minnesota's Sports Medicine Center, is orthopedic consultant for the Twins when they play in Detroit. Perkins worked with Michigan State University varsity athletes while training in East Lansing and remains an MSU athletic consultant. Both doctors are orthopedic consultants for Oakland University and many metro Detroit high schools.

The double-bundle reconstruction, performed by well-trained physicians, provides greater hope for a more complete recovery that takes no longer than it does for the traditional single-bundle procedure, according Perkins.

Because of the complexity of the double-bundle surgery, Samani and Perkins work on each patient as an operating-room team. They view this approach as a new standard in patient care because it minimizes risk.

The doctors perform the double-bundle procedure in several metro Detroit hospitals and surgical facilities, including Beaumont Hospitals, Crittenton Hospital Medical Center, Mount Clemens Regional Medical Center, POH Regional Medical Center, St. Joseph Mercy Oakland, UnaSource Surgical Center (Troy) and Waterford Surgery Center.


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SOURCE Michigan Knee and Shoulder Institute
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