Flanigan and his co-authors are applauded for their fine work investigating the role of bacteria and biofilms in ACL reconstruction and proposing a possible cause for tunnel lysis. The cause of tunnel lysis is still debated, and this important area has seen relatively little investigation. Tunnel lysis in a revision ACL setting causes significant technical considerations and often leads to bone grafting procedures. The MARS Group had a poster at the AOSSM meeting as well on this topic and found that ACL revision patients had lower outcome scores. Our lab has been performing a similar analysis of ACL revision cases and has corroborated these findings, although with smaller numbers. Flanigan found bacterial DNA present in 87% of examined samples and more impressively, were able to correlate tunnel diameter with the amount of bacterial DNA identified. I look forward to seeing this study in its entirety and hopefully continued work in the area.
Brett D. Owens, MD
Orthopedics Today Editorial Board Member
Professor of orthopedic surgery
Brown University Alpert Medical School
Providence, Rhode Island
Disclosures: Owens reports he is a consultant for Mitek, Conmed/MTF and Vericel.