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News

TLS Short Graft ACL Reconstruction – Concepts and Early Surgical Results

22 November 2017

Dr Robert Gordon, clinical and research Fellow to Dr Kelly Macgroarty, recently delivered a presentation at the 2017 Combined Orthopaedic Knee Society meeting, held at Noosa Heads, on “TLS Short Graft ACL Reconstruction – Concepts and Early Surgical Results”. 

The short graft ACL reconstruction technique used by Dr Macgroarty has been developed over the last 10 years in Europe.  There have been more than 40,000 operations of its kind across the globe. Dr Macgroarty was one of the first people in Australia to adopt this innovative technique for anterior cruciate ligament (ACL) reconstructions.

In traditional ACL reconstructions, two Hamstring tendons are harvested and used to create a long, slim graft that is secured in place in large bone tunnels, by either a direct screw into the graft or by a suspension device that sits on the outside of the bone. The graft diameter obtained is often less than 8mm and the types of fixation have a similar strength to the forces that go through the ACL in normal walking.

With the short graft Tape Locking Screw (TLS®) technique, only 1 Hamstring is taken (in 90% of cases) and wrapped 4 times to create a shorter, much larger diameter graft averaging 9mm. It is then fixed in place inside the bone with a screw-tape interface which is 3 times stronger than the traditional fixation.

The larger graft diameter has been shown in studies to reduce the chance of re-rupturing the graft in the future and the superior graft fixation allows for early walking and strengthening to begin, which in turn has a multitude of benefits.

There are major benefits for the patient from sparing a hamstring, including decreased donor site morbidity, improved speed of return of hamstring strength, preservation of future graft source and much greater potential for improved rotational stability.

Furthermore, the larger graft size reduces the chance of re-injury, and stronger fixation allows for earlier rehabilitation and return to walking. 

Overall, the TLS® system represents a safe and effective technique for ACL reconstruction.  It is a less traumatic surgical technique leading to less bony bruising and therefore less pain. This means an earlier return to work and or sports training for the patient.

 

Dr Macgroarty elected as President of the Queensland Shoulder Society in 2015

1 August 2015

Dr Macgroarty was recently elected as the President of the Queensland Shoulder Society at the Winter meeting in 2015. He takes over from outgoing President Dr Mark Ross.

Previously, Dr Macgroarty has served as the Secretary and Treasurer of the Society.

The new Secretary and Treasurer is Dr Ken Cutbush.

Dr Macgroarty organises patellar tendon ACL reconstruction workshop at MERF with Dr Merv Cross

25 May 2015

Dr Macgroarty has recently organised a patellar tendon ACL reconstruction workshop at MERF with world renowned Sydney surgeon, Dr Merv Cross.

Dr Macgroarty had been talking with Dr Cross at last year’s Australian Knee Society when he mentioned that there were a number of local surgeons who had expressed interest in learning patellar tendon reconstruction from the “master”.

Patellar tendon ACL reconstruction is an essential technique to be able to perform for any knee surgeon wanting to manage the entire spectrum of ACL injuries.

The surgical “pearls” that Dr Cross was able to impart to all the participants will ensure that the results obtained by the patients are amongst the very best available when using this technique.

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Dr Merv Cross with Dr Macgroarty immediately on his left and the other participants at the patellar tendon ACL reconstruction workshop in Brisbane

Professor Michael Wirth assists Total Shoulder Replacement Surgery with Dr Macgroarty

30 April 2015

It was with great pleasure that Dr Macgroarty recently hosted Professor Michael Wirth from San Antonio Texas.

Professor Wirth is one of the design surgeons of a new Total Shoulder Replacement system that allows greater flexibility for the surgeon as a result of its increased modularity. It is expected that this new system will help to improve patients outcomes after this type of surgery. Dr Wirth has worked closely over the years with his mentor, Dr Charles Rockwood, who is considered by most to be the father of modern shoulder surgery

Dr Wirth was visiting Australia to give several lectures about osteoarthritis in the shoulder. He took time out from his schedule to assist Dr Macgroarty in 3 shoulder replacements using the new system. Dr Macgroarty was the first surgeon in Australia to use the new shoulder replacement system and has been very impressed with the early results.

Dr Macgroarty on faculty at recent national shoulder symposium.

30 April 2015

Dr Macgroarty was recently invited to be on faculty at the Smith and Nephew A3 Shoulder Symposium. Other members on faculty included several renowned shoulder surgeons from around Australia as well as Dr Jeff Abrams, the current president of the American Shoulder and Elbow Society.

Dr Des Bokor who was chairman for the conference invited Dr Macgroarty to speak about his experience with adolescent athletes with shoulder instability. In addition Dr Macgroarty spoke about his techniques for arthroscopic rotator cuff repair and surgical options available when massive cuff tears are not repairable.

The meeting was well attended by well over 60 delegates with great discussion about all recent and controversial shoulder topics.

Dr Macgroarty travels to France to learn revolutionary new rapid recovery ACL technique

26 January 2015

Dr Macgroarty travelled to France in January 2015 with Dr Price Gallie from the Gold Coast to learn more about a new ACL reconstruction technique that has athletes walking unassisted by three hours post-op. Physiotherapy rehabilitation can be commenced much earlier than traditional techniques allowing athletes a quicker head start on their rehabilitation programme post ACL reconstruction. The accelerated rehabilitation programme makes it possible for the athletes to maintain better muscle bulk and feel stronger sooner which greatly assists the treating physiotherapist.

The new technique still utilises hamstring graft techniques which means that overall return to sport is still expected to be about 7-9 months post surgery.

Dr Macgroarty assisted Dr Thierry De Polignac with several cases at the Clinique Generale Annecy using this new technique. He then spent time following up these patients with Dr De Polignac and the physiotherapists in order to learn more about this new rehabilitation method.

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Dr Macgroarty standing outside the Orthopaedic Hospital in Annecy, France

 

Dr Macgroarty with Dr De Polignac in Annecy, France

Level 2 Sports Physiotherapy Meeting – November 2015

24 November 2014

Dr Macgroarty was invited to speak to the level 2 sports physiotherapists at their recent course at the University of Queensland held in November 2015.

Dr Macgroarty discussed the new short graft hamstring sparing technique in ACL reconstruction as well as commenting on the role for ALL reconstruction techniques to augment ACL reconstruction in certain athletes.

Dr Macgroarty presents latest ACL techniques at 2014 Australian Knee Society Meeting

22 October 2014

Dr Macgroarty presented his case series of hamstring sparing ACL Reconstruction at the 2014 Australian Knee Society Meeting held in Melbourne.

Dr Macgroarty discussed the surgical technique used for the “all inside” short graft technique sparing one of the hamstring tendons normally used in ACL Reconstruction.

In Dr Macgroarty’s series, 22 cases have been undertaken to date with promising early results. Dr Macgroarty outlined that further research is required to confirm the potential long term benefits of this technique.

Dr Macgroarty is currently enrolling patients in a comparative trial looking at early post operative pain relief using the short graft technique with respect to conventional hamstring harvest techniques. He hopes to present his findings at next year’s AKS meeting.

AOA bestows Dr Macgroarty with 2014 Leadership Award

22 October 2014

At the recent AOA Annual Scientific Meeting in Melbourne, Dr Macgroarty was honoured by the AOA board with the 2014 Award for Leadership for fellows under the age of 50. Dr Macgroarty was recognised for his outstanding contributions to the AOA serving on the Queensland branch council and as the Director of AOA training at the Prince Charles Hospital.

Dr Macgroarty was also elected as the new National Chairman of the Australian Society of Orthopaedic Surgeons at the 2014 ASOS AGM.

 

SAWMH Sports Meeting 2014

23 August 2014

Dr Macgroarty was asked to attend as faculty at the SAWMH Sports Meeting held at the Brisbane Hilton Hotel on 23 August 2014.

Dr Macgroarty shared his current experience with a new hamstring sparing technique for ACL Reconstruction. The new short graft technique has been shown in the literature to be comparable to current hamstring techniques for ACL reconstruction whilst showing several key advantages.

The advantages include:

hamstring sparing: – less risk of post-operative hamstring strain / better hamstring strength post op / possibly better proprioception for early rehab / maintenance of secondary postero-medial stabilisers / increased options for revision surgery if necessary

thicker graft size:- far fewer grafts less than 8mm which has been proven to reduce re-rupture rate and improve pt perceived outcomes

less post-operative pain:- hand reaming tunnels decreases bone oedema which can contribute to early post-op pain

 

Dr Macgroarty also discussed the current indications in his practice for antero-lateral ligament reconstruction to augment ACL reconstruction.

The session was rounded off with a discussion of the Congruent arc Laterjet procedure and it’s role in contact athletes following shoulder dislocations and instability.

 

Sports Injury Knee and Shoulder Clinical and Research Fellowship

15 February 2014

Dr Macgroarty has recently established a post graduate fellowship position for all Orthopaedic Surgeons with a special interest in sports medicine in the field of knee and shoulder surgery. The fellowship is endorsed by the Australian Orthopaedic Association.

The fellowship is a six(6) or twelve(12) month position and is open to all qualified Orthopaedic Surgeons.

The fellowship will include clinical work at both the Prince Charles Hospital and St Andrew’s War Memorial Hospital in Brisbane, Queensland, Australia. Successful candidates will spend two and a half days per week in operating theatres which will include their own unsupervised lists. In addition, fellows will attend outpatient clinics and learn the skill of office ultrasound in shoulder practice as well as refining their skills in diagnosis of sporting injuries in the knee and shoulder.

The successful candidate for each fellowship will be enrolled as a member of the Department of Medical Engineering at the prestigious Queensland University of Technology. All research will be undertaken at this institution or at the Medical Engineering Research Facility which is co-located at the Prince Charles Hospital and includes cadaveric laboratories.

The fellowship is exclusively restricted to elective knee and shoulder surgery and there are no on-call requirements. The successful applicant will be expected to work 4 1/2 days per week (Mon-Fri). Any successful candidate will be encouraged to spend time with family and travel so as to gain a full Australian experience.

The fellowship is sponsored by DePuy (Johnson & Johnson) Australia. Remuneration packages will be discussed with all potential fellows upon receipt of application.

Any Orthopaedic Surgeons who are interested in this position should apply by email to kelly@kneeandshoulderclinic.com.au. Please include a current CV with your email application.

Brisbane Football Club links with BKSC

15 February 2014

Dr Macgroarty has been selected to be the team Orthopaedic Surgeon for the Moreton Bay United Football club in 2014.

Dr Macgroarty will work in close relationship with Scott Smith and Robert Thams from Albany Creek physiotherapy to provide medical support to all players throughout the season. Dr Macgroarty has a strong interest in preventative medicine and will work hard to implement additional training programmes to help the club minimise injuries for players this season.

Brisbane AFL Club links with BKSC

15 February 2014

Dr Macgroarty has been selected to be the team Orthopaedic Surgeon for the Aspley Hornets AFL club in 2014.

Dr Macgroarty will work in close relationship with David Anderson from Recoverwise physiotherapy to provide medical support to all players throughout the season. Dr Macgroarty has a strong interest in preventative medicine and will work hard to implement additional training programmes to help the club minimise injuries for players this season.

UFC – Brisbane

8 December 2013

Dr Macgroarty was ringside at the inaugural UFC event held in Brisbane in December 2013 which was telecast to a global audience.

The UFC is the fastest growing sport on the planet and Dr Macgroarty was selected to attend as the local representative Orthopaedic Surgeon. read more…

Global Insights – The Future of Knee Surgery

8 December 2013

Dr Macgroarty travelled to Copenhagen, Denmark to attend the recent Smith and Nephew Global Insights Knee meeting.

Dr Bellemans from Belgium debated the merit of the antero-lateral ligament in ACL reconstruction surgery. There appears to be growing evidence that this is an important structure to consider in the setting of failed ACL reconstruction. In addition to intra-articular ligament reconstruction, there appears to be a place for extra-articular reconstruction of the ALL when undertaking revision ACL reconstruction.

Of the many discussion points during the meeting, it was re-inforced that there is up to a 30% failure of ACL reconstruction (within 2 years) in patient’s under the age of 20.

Royal North Shore Shoulder Symposium 3013

8 December 2013

Dr Macgroarty recently attended the Royal North Shore Shoulder Symposium 2013 in Sydney.

International guest speakers Dr Felix “Buddy” Savoie and Dr Hiro Sugaya discussed the latest techniques for managing glenoid bone loss in instability surgery and rotator cuff repair in the setting of massive tears.

Discussion about safe use of the beachchair position in shoulder surgery also featured prominently.

October 2013 BKSS Physiotherapy Evening

23 October 2013

Dr Macgroarty presented the latest updates on ACL reconstruction at the BKSS physiotherapy educational evening in October 2013.

Dr Macgroarty discussed the relevance of the Antero-Lateral Ligament and how it significantly influences the pivot shift both before and after ACL reconstruction.

Australian Knee Society

14 October 2013

At the 2013 closed meeting of the Australian Knee Society on Hamilton Island in October, Dr Kelly Macgroarty was successfully admitted as a member of the society having completed the necessary entrance criteria.

To be elegible for membership, surgeons must have published an article about knee surgery in a peer reviewed journal, must have presented at, and attended a meeting of the society and must have submitted surgical log books with 50% (or a substantial volume) of knee surgery undertaken in their practice.

Arthrex Mega Shoulder Conference Melbourne 2013

18 September 2013

Dr Macgroarty recently attended the 2 day Arthrex Mega Shoulder Conference in Melbourne held on 30-31 August 2013.

Dr Stephen Burkhart from San Antonio Texas USA and Dr Bradford Parsons from New York City were guest speakers. Latest techniques and controversies in arthroscopic shoulder surgery were discussed over the two days with an excellent local faculty.

Following the course, Dr Macgroarty, Dr John McGuire of Townsville and Dr Brad Parsons continued to discuss all aspects of shoulder surgery while visiting some of Melbourne’s fantastic tourist locations.

Instability Severity Index Score – ISIS

18 September 2013

As discussed at the recent Brisbane Knee and Sports Surgery Physiotherapy Education evening, below is the instability severity index score (ISIS score) that Dr Macgroarty uses to help determine the best treatment for his athletes with antero-inferior shoulder instability after sport injuries. read more…

BKSS Physio Education Night

18 September 2013

Dr Macgroarty was delighted to participate in the recent Physiotherapy Education evening hosted by Brisbane Knee and Sports Surgery at St Andrew’s hospital.

Dr Macgroarty spoke on shoulder instability in the contact athlete. Discussion included selected surgical treatment (Laterjet Procedure) for antero-inferior shoulder instability and new techniques of performing arthroscopic AC joint reconstruction. read more…

Latest update on ACL rupture: differences between males and females

25 March 2013

Key findings of a recent study from the American Academy of Orthopaedic Surgeons (AAOS) highlight the following differences between males and females: read more…

What is a pivot shift test and how significant is it?

25 March 2013

The pivot shift test is the most specific clinical test as it is able to accurately indicate an anterior cruciate ligament (ACL) rupture. The results can be divided into a low-grade tear, which indicates an ACL rupture in isolation, and a high-grade tear which indicates an ACL rupture with disruption of secondary stabilisers of lateral compartment, e.g. anterolateral ligament (see vumedi reference)/ lateral meniscus) ITB. read more…

Anterior cruciate ligament (ACL) reconstruction: mechanism, diagnosis and treatment

25 March 2013

Introduction

One of the most common and serious knee injuries, affecting one in 3,500 people is a tear or rupture of the ACL. read more…

Expert Medical Evidence Lecture

21 March 2013

Dr Macgroarty attended the AMA’s lecture series on giving expert medical evidence hosted at Victoria Park Golf club yesterday.

Being heavily involved in medico-legal reporting, he found it to be very useful and informative.

Medical support crew for Guns n Roses

21 March 2013

Dr Macgroarty was asked to offer Orthopaedic support to the medical crew backstage at the recent Brisbane concert. The concert proceeded uneventfully and was a huge success.

Dr Macgroarty provides medical support for Bruce Springsteen

21 March 2013

At the recent Brisbane show, Dr Macgroarty was backstage as part of the medical support crew. Along with Dr Sean Rothwell, Emergency Physician at St Andrew’s hospital, Dr Macgroarty was there to offer Orthopaedic support.

The show went uneventfully and was a huge success.

Deep Purple base guitarist visits Dr Macgroarty’s practice

6 March 2013

During their recent tour of Brisbane, base guitarist Roger Glover was reviewed by Dr Kelly Macgroarty at his Wickham Terrace rooms. Following treatment Roger successfully played his gig before heading to Melbourne.

Junior Rosalea playing again with Western Force

5 March 2013

Junior suffered a serious knee and shoulder injury late in 2012 whilst playing with the Australian Sevens Rugby team. Although the knee injury responded to conservative treatment his shoulder injury required surgery. Dr Macgroarty  performed the successful shoulder surgery in November 2012 and Junior is already back playing with the Western Force.

Patients should be aware that responses to surgery vary between patients.

Australian Knee Society 2012

5 March 2013

Dr Macgroarty presented his published study on the assesment of fixed flexion deformity in total knee replacement when comparing navigated and conventional techniques. Visual assessment alone is often misleading in determining degree of FFD pre-/intra- and post-operatively.

SESA 2012

5 March 2013

Dr Macgroarty presented his case series of patients undertaking arthroscopic reconstruction of the AC joint using the LARS ligament. Early follow up has been promising with no failures to date. Further assessment is required to confirm long term results of the technique.

 

MEMBERSHIPS

 

American Academy of Orthpaedic Surgeons Australian Orthopaedic Association   Royal Australian College of Surgeons    International Society of Arthoscopy, Knee Surgery & Orthpaedic Sports Medicine     Queensland Shoulder Society

 Australian Knee Society  Shoulder & elbow society of Australia  Australian_Medical_Association    SPORTS MEDICINE AUSTRALIA    american board of independent medical examiners

     

AFFILIATIONS

 

ST ANDREWS WAR MEMORIAL HOSPITAL  RAMSAY HEALTH CARE   GREENSLOPES PRVATE HOSPITAL           BRISBANE KNEE AND SPORTS SURGERY