ACL deficiency directly affects a large portion of the Workers’ Compensation population. At the present time there is no consensus or good scientific evidence to determine what is the best surgical procedure. There are various options to restore the ACL, including using the patients’ own patellar or hamstring tendons to create a new ACL. A relatively newer technique using the same hamstring tendons is the so-called “double-bundle reconstruction.”
The primary objective of this research is to compare these three graft options by measuring the quality of life of patients at 1, 2, 5 and 10 years after ACL reconstructive surgery (this funding allows us to begin the 5-year follow-up studies).
The secondary objectives are to evaluate the long-term consequences of developing arthritis by comparing x-rays from before and after the surgery at 2, 5 and 10 years. The study will very carefully document whether there are any surgical failures, re-injuries, complications, surgical times, and the stability and range of motion in the knee. The work status of the patients will be measured by the Cincinnati Occupational Rating Scale that has been specifically developed to assess ACL patients.
This well-designed and adequately powered randomized clinical trial (RCT) will advance the scientific knowledge by addressing the controversy of graft selection, evaluating the new double-bundle technique, and providing the mid- and long-term clinical and quality of life outcomes that are lacking in the current literature. The target groups that will benefit from this research
include patients, physicians and surgeons, employers and the Workers’ Compensation Board. Future patients/workers will benefit because this study will provide the best clinical evidence regarding optimal graft choice for surgical treatment of ACL deficiency. In the short-term, this trial will provide evidence for the procedure that provides the most optimal return to work and quality of life outcomes. In the long-term, the results will provide evidence regarding which surgical procedure may be more likely to minimize the impact of developing post-traumatic osteoarthritis.
Dr. Nicholas Mohtadi, Ms Denise Chan (University of Calgary)