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Ligament injuries around the knee have been on the rise in the past three decades following an increase in participation in recreational and competitive sporting activities. According to an ongoing study in the United States, an estimated 200,000 anterior cruciate ligament (ACL) reconstructions are performed annually and the incidence of ACL injury is roughly one in 3000 per year. ACL is in the center of the knee joint; its function is to prevent the forward sliding of the tibia. ACL may be injured through contact placing force on the ligament or may be produced without contact by rapid twisting of the knee. Symptoms of ACL tear include immediate onset of pain, swelling, instability and limitation of range of motion. ACL tear is confirmed by MRI scans.

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We utilize biological augmentation for partial ACL lesions along with primary fixation of the ligament. Cellular therapies offer an interesting option in the treatment of injured ACL by addressing the defect in healing at a molecular level and leading to a more biological way of healing. Recently we published a study on the possibility to modulate mesenchymal stem cells (MSCs) to enhance the healing of a repaired ACL. We re-approximate the torn part of the ligament with sutures and performing bone marrow stimulation (BMS)  by penetrating the area around the anatomic femoral insertion of the ACL, in order to recruit bone marrow derived MSCs to promote healing. An additional growth factors injection into the torn ligament is made consequently. Our technique showed favorable results at short and medium term follow-up with significant improvement in all the evaluated knee scores and safe return to previous sport activities.

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