4 ms·

Interesting related article I think I saw here a while ago: Healing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical mana

Interesting related article I think I saw here a while ago: Healing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical management with the Cross Bracing Protocol https://bjsm.bmj.com/content/early/2023/06/13/bjsports-2023-106931 https://bjsm.bmj.com/content/early/2023/06/13/bjsports-2023-... TL;DR they braced the knee at 90 degrees flexed and saw evidence of some healing in 90% of enrolled patients after 3 months

pr0zac 3y ago
Isn't this common treatment already? Don't actually know, just remember my stepmom and everyone else I've known that had knee surgery getting a cool knee scooter thing to roll around on for the months long recovery period.
- jaggederest 3y ago
  No, this is instead of surgery, as far as I can tell just splinting it bent at 90 degrees to allow it to heal.
- swader999 3y ago
  My wife healed her fully severed mcl without surgery. It's difficult but possible. You have to be really disciplined and follow the protocol.
  - jaggederest 3y ago
    From what I gathered from the article abstract I posted above, this is unique because it's a protocol for healing a fully severed ACL, where the MCL heals much more readily than the ACL apparently for reasons of blood supply and positioning. I love it when doctors can use conservative treatment to avoid the need for surgery though, very exciting when a natural process can do the work. If you have any anecdotal discussion from your wife's experience I'd be interested to hear more about it - I haven't banged up my knees yet but it's just a matter of time, already down some functionality in an ankle.
    - swader999 3y ago
      Yes, although if you have a few million and access to a daily MRI you can even heal a PCL this way. See the Connor McDavid documentary "Whatever it Takes". For my wife, it was strict bracing at specified angles with forced stretching to retear the tendon at periodic intervals as it healed. She was on advil and a cryo cuff immediately after injury which really helped. I'd recommend having a cryo cuff on hand or a plan to quickly get one if knee injuries are likely in your future. Look into red light therapy for ankle, for example: https://a.co/d/7CPLFkl https://a.co/d/7CPLFkl
steve76 3y ago
[dead]
5555624 3y ago
Discussed at the time: https://news.ycombinator.com/item?id=36594634 https://news.ycombinator.com/item?id=36594634
taneq 3y ago
This seems to be saying that a completely torn ACL will actually reconnect if the knee is kept immobilized? I did my ACL and in the MRI it was just gone aside from a fuzzy puddle on top of my tibia, it'd be incredible if that could regrow. > knee immobilisation at 90° flexion in brace for 4 weeks, followed by progressive increases in range-of-motion until brace removal at 12 weeks Compared with an ACL reconstruction with Gracilis tendon graft (the procedure I had), I wonder if complete immobilization for four weeks might do more damage than just having the surgery. I was limping but still loading up the leg as much as possible for four weeks after the accident and then off it for a week after surgery, and the muscle loss and general degredation was severe. It took months of physio and most of a year of exercise to rebuild back to ~95%. Taking 2-3 months to get weight back on it sounds light it could be worse overall.
- throw1234651234 3y ago
  If it grows back "correctly", that's still way better than surgery, since who knows if they "get it right".
  - taneq 3y ago
    That's no more convincing than "If the surgery 'goes well,' that's still way better than just leaving it, since who knows if it grew back 'correctly'."
throw1234651234 3y ago
Is "rupture" a full tear? The "common knowledge" is that "ligament full tears can't heal". In fact, 10 years ago, people were told that partial tears can't heal either, and you might as well not bother.
- trogdor 3y ago
  >Is “rupture” a full year? Yes. Complete discontinuity of ACL fibers on MRI.

pr0zac 3y ago

Isn't this common treatment already? Don't actually know, just remember my stepmom and everyone else I've known that had knee surgery getting a cool knee scooter thing to roll around on for the months long recovery period.

jaggederest 3y ago
No, this is instead of surgery, as far as I can tell just splinting it bent at 90 degrees to allow it to heal.
swader999 3y ago
My wife healed her fully severed mcl without surgery. It's difficult but possible. You have to be really disciplined and follow the protocol.
- jaggederest 3y ago
  From what I gathered from the article abstract I posted above, this is unique because it's a protocol for healing a fully severed ACL, where the MCL heals much more readily than the ACL apparently for reasons of blood supply and positioning. I love it when doctors can use conservative treatment to avoid the need for surgery though, very exciting when a natural process can do the work. If you have any anecdotal discussion from your wife's experience I'd be interested to hear more about it - I haven't banged up my knees yet but it's just a matter of time, already down some functionality in an ankle.
  - swader999 3y ago
    Yes, although if you have a few million and access to a daily MRI you can even heal a PCL this way. See the Connor McDavid documentary "Whatever it Takes". For my wife, it was strict bracing at specified angles with forced stretching to retear the tendon at periodic intervals as it healed. She was on advil and a cryo cuff immediately after injury which really helped. I'd recommend having a cryo cuff on hand or a plan to quickly get one if knee injuries are likely in your future. Look into red light therapy for ankle, for example: https://a.co/d/7CPLFkl https://a.co/d/7CPLFkl

steve76 3y ago

[dead]

5555624 3y ago

Discussed at the time: https://news.ycombinator.com/item?id=36594634 https://news.ycombinator.com/item?id=36594634

taneq 3y ago

This seems to be saying that a completely torn ACL will actually reconnect if the knee is kept immobilized? I did my ACL and in the MRI it was just gone aside from a fuzzy puddle on top of my tibia, it'd be incredible if that could regrow. > knee immobilisation at 90° flexion in brace for 4 weeks, followed by progressive increases in range-of-motion until brace removal at 12 weeks Compared with an ACL reconstruction with Gracilis tendon graft (the procedure I had), I wonder if complete immobilization for four weeks might do more damage than just having the surgery. I was limping but still loading up the leg as much as possible for four weeks after the accident and then off it for a week after surgery, and the muscle loss and general degredation was severe. It took months of physio and most of a year of exercise to rebuild back to ~95%. Taking 2-3 months to get weight back on it sounds light it could be worse overall.

throw1234651234 3y ago
If it grows back "correctly", that's still way better than surgery, since who knows if they "get it right".
- taneq 3y ago
  That's no more convincing than "If the surgery 'goes well,' that's still way better than just leaving it, since who knows if it grew back 'correctly'."

throw1234651234 3y ago

Is "rupture" a full tear? The "common knowledge" is that "ligament full tears can't heal". In fact, 10 years ago, people were told that partial tears can't heal either, and you might as well not bother.

trogdor 3y ago
>Is “rupture” a full year? Yes. Complete discontinuity of ACL fibers on MRI.