Research in Action: - University of Calgary

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Dr. Cy Frank has performed countless knee surgeries and helped people get back on their feet after ligament injuries. All these operations—the majority of which involve using tendons from the knee to repair torn ligaments—have left him with one inescapable conclusion: “There has to be a better way.” Frank acknowledges that the current method of arthroscopic surgery is a vast improvement over the methods of 20 years ago but he adds “it’s still fairly barbaric—drilling holes through the joint, disabling people for months.” 20 UofC Research in Action A better way to heal One aspect of his work toward finding that “better way” focuses on the healing process. “All the ligaments we’ve studied heal with scar tissue and not ligament regeneration,” says Frank, professor of orthopaedic surgery, an Alberta Heritage Foundation Medical Research (AHFMR) scientist, executive director of the Alberta Bone and Joint Health Institute and winner of the U of C’s Distinguished Alumni Award in 2002. “Scar tissue is better than nothing but it’s not the same as normal ligaments.” Frank says scar tissue is about 30 percent as good as a normal ligament and that getting injured knees back to normal is the goal. But there are lots of factors to consider when investigating “how to optimize ligament healing, to make them tighter and stronger.” One method involves intentionally stimulating the size of ligament scar tissue. “If you use more of an inadequate material you can compensate,” he says. “For example, if you have a scar that is one-third as good but three times as big as the normal ligament, it actually can be as strong as normal.” The problem with this method is that it wouldn’t work for cruciate ligaments, as space within the knee is severely restricted, limiting the amount of scarring that can be created. “Growing” ligament tissue Another new technique being explored by the team in Calgary involves looking for stem cells to create new ligaments. If successful, this approach could involve “growing” more normal ligament tissue in the lab and then implanting it. A simpler method of improving ligament healing might be to reduce the amount of inflammation caused by the surgery. “We’ve got some evidence that the inflammation caused by drilling through the knee could be a cause of on-going scar weakness and some of the arthritis that develops,” Frank says. “We now have a Canadian Institutes for Health Research grant to study how to prevent the inflammation to see if that can prevent some of the arthritis and improve the quality of the grafts.” Dr. Cy Frank is focused on the healing process to find a better way to treat knee injuries.
One element of Dr. Cy Frank’s research involves intentionally stimulating the size of ligament scar tissue. With the surgery, the repaired ligament is about 80 percent as strong as a normal tendon; this method could get “that other 20 percent back,” Frank says. If he can do that, he’ll also improve the quality of life for many people who suffer knee ligament injuries. Bone and Joint 21
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Research in Action: - University of Calgary

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