In this week's episode, we speak to Dr Steven Duhig, No. 42 of the first 80 patients in the Cross Bracing Protocol case series of the novel bracing protocol. In this episode, Steven discusses why he decided to enter the protocol after rupturing his ACL playing football.  He has plenty of advice and feedback for people considering their management options and gives a view into the future of ACL management.

The Knee Gurus is an educational podcast hosted by physiotherapist Bevan Colless. Bevan has a special interest in knee injuries and operates Asia Physio, with clinics in Niseko, Nozawa, Hakuba, Myoko, Tokyo, Singapore and Okinawa.

After a hiatus, The Knee Gurus is back to bring more content for people interested in best practice management of knee injuries.  
During our time off, a lot has occurred in knee injury management. 

Tech has made its way into knee management, with objective measures using devices made to measure strength and power. they are moving from the professional sporting club sphere into private health setting for the general public. We outline this move and have some interviews with key players in this area lined up.

The publishing of the Cross Bracing Protocol (CBP) has seen many people question long held beliefs around ACL healing and acute care management. We give a brief outline into the study and have some intervies lined up with researchers and participants.

 

We were very fortunate to share this fascinating story of professional rugby player Mitch Short, and the ACL rupture he suffered on debut. Mitch is joined by long-time NSW Waratahs and current Australian Wallabies team doctor Sharon Flahive, who was the treating physician at the time. 

In 2018,  Mitch Short was the third-choice scrum-half for the NSW Waratahs rugby team. Prior to a tour to South Africa to play the Bulls in Durban, first-choice half Nick Phipps was down with a calf strain, so Mitch was on the bench set to make his Super Rugby debut. With about 15 minutes remaining in the game, Mitch came on, and with one of his first touches of the ball, he twisted and felt his knee go numb. Mitch completed the game and even scored a try but the medical staff later confirmed that he had ruptured his ACL.

It became apparent very early on that Mitch was an 'elite coper' and continued to function at a very high level as the tour continued to Argentina. After the second-choice scrum-half Jake Gordon suffered a concussion, Mitch was next-in-line to make his run-on debut. But could he start a game of international standard rugby with a recently torn ACL? Listen in as we hear the full story from Mitch and Dr Flahive.

In this episode we speak with Professor Evangelos Pappas, Associate Dean and Professor at University of Wollongong, where he is working on development of the Health and Wellbeing precint and commencing research into long-term outcomes from ACL injuries

His research focuses on the aetiology, prevention and treatment of athletic knee injuries

Prior to his move to the University of Wollongong he previously worked at University of Sydney where he continues to head  a large team researching ACL injuries.

In this episode we talk about his career path in researching ACL injuries,  ACL healing and how the definition of healing may be causing some widely different healing statistics. We discuss ACL repairs and reconstruction and the pros and cons of each. We delve into the gender difference in ACL injuries and try to work out why females are at much greater risk. We talk about long term outcomes post ACL injury, discussing long term participation in sports, osteoarthritis rates and what we can do to keep people active and reduce the chances of arthritis. We also talk about how we need to avoid a inter-professional turf war and what to look for in choosing a health profession to get advice from on managing ACL injuries.

In this episode we speak with Orthopaedic surgeon, MMA fighter, ringside doctor and all-round nice guy, Dr. Alan Cheung. 

He has a special interest in martial arts and is a member of the Association of Ringside Physicians and is a certified Ringside Physician and provides coverage for several international combat sports events

In this episode we delve into the latest developments in ACL research and practice, discuss  his involvement in combat sports and why he puts his valuable hands at risk by continuing to compete in martial arts himself! We discuss the different types of ACL grafts and the pros and cons of each, and the difference in ACL grafts between countries, when is a good time to operate and what factors should be considered when deciding whether to operate or not. We finish up by discussing knee replacements.

In this episode we delve deep into the best options for people who have recently ruptured their ACL with Kieran Richardson. Kieran is a specialist musculoskeletal physiotherapist who has a Master's in Clinical Physiotherapy from Curtin University, and is founder of Global Sports Physiotherapy, a consultancy company of academics, researchers and educators offering formal mentoring second opinions for complex patient presentations. Kieran has a special interest in evidence based non-surgical management of the anterior cruciate ligament. 

https://globalspecialistphysio.com

 There is probably no one on the planet who has researched the best practice management of ACL injuries as extensively as Dr Stephanie Filbay.

 Stephanie is a physiotherapist graduate from La Trobe University in Melbourne in 2010 and was awarded her Ph.D. in 2016 on Longer-Term Outcomes after ACL injuries with a specific focus on quality of life. Stephanie was also based in Oxford University in the UK where she was a Senior Research Associate in Orthopaedics, Rheumatology and Musculoskeletal Sciences. She is currently a senior research associate and NHMRC fellow at the University of Melbourne and her research focuses on optimising outcomes for people with ACL injury and knee osteoarthritis.

In this episode we speak with Stephanie about all aspects of ACL management. 

We delve into the research behind the common beliefs around ACL reconstructive surgery (ACLR) 

Does ACLR reduce osteo-arthritis?
Does ACLR reduce the chance of meniscus tears on return to sport ?
What are the impacts of quality of life post ACL rupture?
Psychological aspects of ACL healing.
Can the ACL Heal? 
Optimal timing of the ACL surgery post injury. Shared  decision making process for ACL management and how to choose a surgeon.

See the links below to read the papers we discuss in the interview. 

https://www.sciencedirect.com/science/article/pii/S1521694219300191?via%3Dihub

https://bjsm.bmj.com/content/bjsports/early/2017/05/17/bjsports-2016-097124.full.pdf

https://bjsm.bmj.com/content/49/16/1033.long

https://bjsm.bmj.com/content/53/8/459

https://www.sciencedirect.com/science/article/pii/S1836955316000205

Welcome to the knee gurus, bought to you by Asia Physios founder Bevan Colless, here at the knee gurus we aim to bring you all the latest research and updates in knee injury management from world leading experts. So whether you are recently injured, recovering, getting back to full health, or a health professional, tune in weekly to keep up to date with all the news. 

Thanks for listening!