Rework cross in ACL

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Aug 6th, 2022
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How to rework cross in ACL

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welcome to the wild physio podcast with your host Andrew Wilde today I welcome back Dr Tom cross who featured on the Dr Merv cross podcast episodes last year we touched on the cross bracing protocol last time Tom featured but today we can finally talk in detail about Tomamp;#39;s pointing research Tom has practiced sports medicine since 1997 and he has a broad Sports Medicine experience caring for recreational athletes muscular injuries that occur at work or home and Elite professional athletes and also military personnel as mentioned today we will be discussing the Revolutionary cross-bracing protocol for ruptured ACL injuries this protocol was pioneered by Tom and his father Dr Merv cross and it has yielded research that was published last week finally in the British Journal of sports medicine Dr cross has been a huge influence on my career and I canamp;#39;t thank him enough for his ongoing support a huge welcome to Dr Tom cross thanks very much Andrew thanks for coming on mate th

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The Cross Bracing Protocol involves immobilising the leg at 90 degrees for four weeks and then gradually increasing the range of motion via a specific schedule until full extension is docHubed and the brace can be removed. This approach has shown ACL healing in 90% of cases and shown many promising results.
What are the results? Even though almost 700 people have been braced, the first research published on the protocol in June 2023 only looked at the initial 80 participants. It found that at the 12-week mark, 90 per cent of ACLs had healed.
There is no real limit to the amount of times the ACL can be reconstructed. However, each successive surgery may become technically challenging due to bone loss. This requires that your surgeon have expertise in complex revision ACL surgery. How can you tell if you torn your ACL again?
It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation. Many patients can expect a full return to activities in 9-12 months if rehabilitation protocols are followed.
The best means to determine if an ACL reconstruction graft is torn is by either the patients history or by a good clinical exam. Unfortunately, MRI scans are not very effective for determining the function of an ACL graft.
26 weeks beginning to walk normally without pain relief or crutches. 614 weeks full range of motion restored able to climb up and down stairs. 35 months able to do activities such as running without pain (but still avoiding sports) 612 months return to sport.
Conclusion. Multiple revision ACL reconstruction surgery appears to have reasonable functional outcomes but is associated with a relatively high failure rate. Activity level following repeat revision surgery is diminished compared to the preinjury state, but most patients are able to return to recreational sports.
In general, the success rates in the literature for ACL revision surgery are approximately 75%. A very careful assessment of the cause of the graft failure is necessary to try to maximize an individual patients outcome with an ACL revision surgery.

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