Conor McGregor’s ACL Injury & What Today’s ACL Treatment Looks Like

By popular demand, and following many questions, I want to discuss one specific injury on today’s Dr Rick Informs. Conor McGregor’s right ACL injury at UFC 329.

At the beginning of the fight, McGregor had his right leg planted when it appeared that his knee experienced rotational stress. He then had multiple episodes of instability over the following minute before the fight ended.

Dr Rick looks to use this injury as a springboard to explain the latest developments in ACL treatment. For people who have experienced an ACL injury, or have a family member who has, here is where ACL surgery and rehabilitation stand today.

ACL Treatment Is Becoming More Personalized

ACL surgery is no longer based on one operation that fits every patient.

The treatment approach can depend on several factors:

• Age
• Sport
• Tear location
• Hyperlaxity
• Associated injuries
• Tibial slope

All of these factors are considered when determining the appropriate treatment.

Which Graft Should Be Used for ACL Reconstruction?

The quadriceps tendon has become a popular graft option for ACL reconstruction.

In Dr. Rick’s opinion, however, bone-tendon-bone remains the gold standard. For a high-level athlete such as Conor McGregor, he would recommend a bone-tendon-bone reconstruction.

This procedure uses the patellar tendon, with bone taken from the patella and the tibia. Tunnels are drilled across the knee, and the ACL graft is fixed at both ends.

For a more comprehensive overview, read our guide on ACL surgery, graft options and recovery.

Can an ACL Be Repaired?

Certain types of ACL injury may be suitable for repair rather than reconstruction.

ACL repair was attempted in the past without success, but it has since regained popularity. I have performed approximately 40 to 50 ACL repairs with very successful results.

However, repair is only appropriate in selected cases and for certain types of tears.

What Is the Future of ACL Reconstruction?

The next development in ACL treatment is likely to be augmented ACL reconstruction.

Potential methods include:

• Platelet-rich plasma, or PRP, injections into the knee
• Exosomes
• Growth factors
• Scaffolds
• Bioactive implants

The aim is to enhance healing and improve graft incorporation.

What Is New in ACL Rehabilitation?

ACL rehabilitation is also continuing to develop.

Current rehabilitation tools include:

• Force plate analysis
  GPS tracking
• Movement analysis, such as VUE MOTION®
  Blood flow restriction, or BFR

How Long Does It Take to Return to Sport?

Returning to sport after ACL reconstruction should take approximately nine to 12 months.

Some athletes may feel ready to return after four or six months. However, graft incorporation takes nine to 12 months, and the risk of retearing the ACL increases significantly if an athlete returns too early.

Factors that can contribute to a retear include:

• Quadriceps weakness
• Poor neuromodulation
• Incomplete graft incorporation

You have to give the graft time to bake. Think of it like a cake: if it takes 10 to 12 minutes to bake, it will not be ready to eat after six minutes.

Even if an athlete feels ready sooner, the graft still needs time.

The Future of ACL Care

Looking ahead, the future of ACL treatment may include:

• Robotics
• Artificial intelligence in rehabilitation
• Artificial intelligence in surgery
• Orthobiologics
• Minimally invasive ACL reconstruction
• The Bottom Line

ACL treatment is becoming increasingly personalized. The appropriate approach depends on the patient, their sport, the location and type of tear, and other characteristics of the knee.

Bone-tendon-bone remains my preferred reconstruction for a high-level athlete, while ACL repair may be an option in selected cases. New technologies may also enhance surgery, healing and rehabilitation in the future.

Whatever treatment is selected, returning to sport should take nine to 12 months. The graft needs time to bake.

Conor McGregor, best of luck with your recovery. Let’s rock and roll.