Join host Phil Plisky, PT, DSc, ATC, CSCS, as he sits down with Matt Daggett, DO, MBA, a dual fellowship-trained orthopedic surgeon and leading member of the international SANTI research group. Together, they explore the evolving landscape of ACL reconstruction, moving beyond traditional graft debates to discuss the critical role of lateral extra-articular procedures (LEAP) in reducing reinjury rates. You’ll gain expert perspective on individualizing graft selection—including the promising rectus tendon autograft—and why addressing the "lateral side" of the knee is essential for long-term stability in high risk athletes. From debunking trends such as the cross-bracing protocol to mastering criteria-based return-to-sport transitions, this conversation provides the practical, evidence-based tools you need to optimize patient outcomes.

Learning Outcomes

• Analyze the evidence around graft selection for ACL reconstruction and the use of lateral extra-articular procedures (LEAP) to improve rotational stability and reduce graft failure
• Apply evidence-based, practical strategies to actionably address rehabilitation progression, return-to-sport timing, and the management of arthrogenic muscular inhibition (AMI) following ACL reconstruction
• Solve patient case scenarios involving ACL reconstruction graft selection based on patient demographics, sport-specific demands, and individual risk factors

Timestamps

• (00:00:00) Welcome
• (00:00:05) Introduction to ACL reconstruction and graft selection
• (00:02:18) Diverse perspectives in orthopedic surgery
• (00:04:20) Types of grafts for ACL reconstruction
• (00:08:45) Concomitant procedures and lateral knee stability
• (00:11:19) An overview of LEAP
• (00:15:25) Understanding combined instabilities in ACL injuries
• (00:18:44) Consensus statements and recommendations
• (00:21:48) The evolution of ACL surgery techniques
• (00:26:26) Cross-bracing protocol: a critical review
• (00:28:50) Decision-making in surgical procedures
• (00:32:18) Graft choices: hamstring, quad, and rectus
• (00:35:05) Rehabilitation perspectives and early activation
• (00:41:10) Return to sport: psychological readiness and timeframes
• (00:46:58) Key takeaways and future innovations

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