Internal Brace - a groundbreaking ligament repair technique designed by a former soccer player

An ACL (anterior cruciate ligament – the main ligament through the centre of the knee which keeps the joint stable) injury used to be viewed as the dreaded curse for footballers, as a return to the game was not always guaranteed. Advancements in technology mean it is not the career death knell it once was, but there is still a 10 per cent re-injury rate and some players still don’t get back to the level they were at before.
Mackay’s method is a less traumatic alternative to traditional reconstruction: repairing the ligament as soon as possible and augmenting it with an internal brace (IB). “A ligament repair tries to retain all the natural tissue, so the injured ligament can heal again. The IB idea is that it protects the ligament so it is fully healed. Whereas a reconstruction is taking a part of the ligament from the hamstring to replace the damaged ligament.
“Why can’t we protect things and mobilise them while we heal?’. We do it with external braces. Why don’t we do it internally by matching the natural ligament? Don’t replace it, let it heal and just protect it.
“We’ve found that we can use a hybrid, which is a slightly reduced graft in size. We keep the stump of the damaged ligament so you’ve still got nerve supply and blood supply, and back it up with this internal brace. like a ribbon, but it significantly improves the strength of the reconstruction. We’ve also found recently that, with the addition of a second internal brace on the outside of the knee, you can reduce the risk of re-injury by a further third.

Recovery time was around a minimum of nine months to get back to playing, but former Aberdeen and Dundee United defender Mark Reynolds’ return was reduced to just four-and-a-half months courtesy of Mackay’s IB repair in 2018, while now-Rangers winger Scott Wright was fully recovered in the same timeframe after an ACL tear playing for Aberdeen the following year. Re-injury rate is a 1.1 per cent in five years, which was reduced considerably.

The IB was first devised as a concept by Mackay in 2011 and, in conjunction with leading US-based sports-surgery company Arthrex – which has applied the technique to 17 different areas of the body and taken it to 30 different countries – the number of surgeries to have been performed using his patented method has passed one million. Last year alone, 50 per cent of soft-tissue knee surgeons started to introduce the IB for reconstruction, and there are now 214 academic papers on its role in recovery and accelerated healing. The IB has been adopted by the US special forces, which has returned troops to free-fall parachute jumps just two-and-a-half weeks after ankle-ligament damage.

Adapted from: https://www.mackayclinic.co.uk/, https://theathletic.com/4076512/2023/01/11/gordon-mackay-internal-brace/...
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