Interview with
Dr Matej Drobnič

Ligamys is a method for the management of cruciate ligament ruptures in which the patient’s own cruciate ligament and its functions are preserved. In contrast to other methods, no endogenous tendon has to be sacrificed. Until the torn cruciate ligament grows together again and can regain its full functionality, the knee joint is dynamically stabilised by the implant.

Today in Interview Dr Matej Drobnič with his personal experience report on Ligamys and a small success story.

Dr Matej Drobnič

Dr Matej Drobnič is a full professor at the Medical Faculty, University of Ljubljana, and a consultant orthopedic surgeon at the Department of Orthopedic Surgery, University Medical Centre Ljubljana, Slovenia. He is also founder of and consultant for sports orthopedics at the Institute of Medicine and Sports in Ljubljana. His clinical work is subspecialized on arthroscopy, sports traumatology, and reconstructive surgery of the knee and foot/ankle. Besides his clinical and teaching obligations, he is dedicated to research and novel applications of cartilage repair and tissue engineering. He has been enrolled in 18 national and 4 international research projects. His academic activity resulted in over 200 publications and more than 80 lectures. He is a former secretary of the Slovenian Orthopedic Association and current president of Slovenian Cell and Tissue Engineering Society. He is an active member of many international orthopedic and sports medicine societies (ICRS, ESSKA, BAFAS, EFSMA). He has been serving on the editorial board of the American Journal of Sports Medicine since 2011. He is a team physician for the football team NK Olimpija, Ljubljana, and a member of medical commissions of the Football Association of Slovenia. He has been active as lead physician of the Slovenian national ski-jumping association and was among the team physicians at the Winter Olympic Games in Beijing 2022. 


What is your experience with Ligamys in terms of clinical outcome?

We started with the Ligamys surgeries at our orthopedic university hospital in 2015. The introduction of this novel ACL-preserving strategy faced logistical obstacles – mostly where it came to timely imaging and hospital admission. Considering the limited patient cohort, the first results we achieved were very good with minimal revision rates. And I have kept Ligamys in my ACL surgery armamentarium ever since. 

«And I have kept Ligamys in my ACL surgery armamentarium ever since.»

According to clinical data, young patients and patients who are very active in sports are at higher risk of re-rupture or knee instability. Why did you decide to treat them with Ligamys in this case?

I am well aware of possible re-ruptures after Ligamys in elite athletes. Working closely with our national ski-jumping team for some years, I have become familiar with the specifics of this sport. The exact muscle coordination in a split second at the take-off table is of utmost importance for top sport performance. When Ema Klinec was injured for the first time in 2014, her other knee was operated on using a standard hamstring ACL reconstruction. Despite knee stability, she experienced prolonged muscular dysfunction and was not able to return to elite level for nearly two years. She unfortunately suffered another ACL injury, this time of her left knee, in 2019. MRI revealed a proximal ACL tear with a preserved stump, so we started discussing the Ligamys option with Ema and her coaches. The elite ski-jumpers do have an asthenic constitution; their knees are relatively small-sized, and they tend to execute less uncontrolled pivoting in comparison to ballplayers. Agreement in favor of Ligamys was reached, the recovery was much faster, the outcome was perfect, and the rest is history. Encouraged by Ema’s successful surgery, we did not hesitate to offer the same procedure to Urša Bogataj in 2020. 

You successfully treat young athletes. How do you inform these patients before a possible Ligamys operation?

Before any discussion on the pros and cons of Ligamys, I first use the MRI to ascertain whether the procedure is feasible in the first place. I am still reluctant to offer this surgery for aggressive pivoting sports but keep it as a valuable treatment for small-to-medium sized knees, without gross instability. All patients need to understand that we may have to resort to a classical ACL reconstruction during the surgery. 

According to the Ligamys rehabilitation program, a return to sports should be envisioned only six to twelve months postoperatively. In addition, patients are advised to undergo a back-to-sports test. How did you manage to balance the training plans for Ms. Urška Bogataj and Ms. Ema Klinec with the restrained post-Ligamys treatment?

Ski-jumpers, according to my experience, are very dedicated and compliant patients. The early post-operative period with Ema and Urša was smooth. As they both required also a meniscus repair, the early post-op phase was even slower.  

«The return to sports was actually quite fast.»

After 6 months, they underwent laboratory and field testing, and afterwards they started individualized sport-specific rehabilitation. As their knees were clinically stable and symptom-free, we did not conduct any control MRI. The return to sports was actually quite fast, and they both returned to ski-jumping after 7 months. Since then, they have joined their teammates in routine training. As the dynamic tibia screws do not bother any of them, we did not push to remove them as yet. 

What do you say about the success at the 2022 Winter Olympics of Ms. Urška Bogataj and Ms. Ema Klinec in relation to Ligamys?

Together with the entire ski-jumping team, I was very impressed and proud of the girls’ results. Ema Klinec became female world champion in 2021, and Urša was just amazing as double-gold medalist at the Winter Olympics in Beijing 2022. And these tremendous results were achieved just at the two-year time frame post-surgery. I will always remember one of the first words of Urša Bogataj, after her final jump confirming the Olympic victory: «Thank you for my knee.»

Dr Matej Drobnič, thank you for this interview!

This interview reflects solely the opinion of Dr Matej Drobnič.

«Thank you for my knee.»

Urša Bogataj was just amazing as double-gold medalist at the Winter Olympics in Beijing 2022 and Ema Klinec became female world champion in 2021.

«And these tremendous results were achieved just at the two-year time frame post-surgery.»


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