Preventing the Next ACL Tear: How Researchers from NC A&T and UNCG Are Rethinking Knee Injury Risk
Going down with a knee injury — it’s a risk that never fully disappears, whether on the pickleball court or the softball field. But increasingly, it’s not just adults who are getting hurt. Adolescents and young adults, particularly females, are tearing their ACLs at growing rates — and the consequences can follow them for life.
Unlike many other injuries that heal with time, a torn ACL can lead to lasting problems: reduced mobility, arthritis, and increased body mass that together compromise long-term health.
While at the University of North Carolina at Greensboro, Dr. Randy Schmitz and Dr. Sandy Shultz spent more than two decades investigating why this happens and how to stop it.
“About 20 years ago, we asked ourselves, ‘Why are we seeing this epidemic of knee injuries in young girls?’” Dr. Schmitz said. “If they sustain an ACL injury early, it leads to arthritis, which leads to decreased mobility later in life, and ultimately greater morbidity.”
“The goal,” Dr. Schmitz resolved, “is to find what’s causing this injury so we can prevent it.”
Their work led them to an important clue: joint laxity — a natural looseness in the knee’s supporting ligaments. The looser the joint, the greater the likelihood of a first-time ACL injury. Identifying that risk early could make a major difference.
A device that allows medical providers to quickly, precisely and affordably check knee laxity — perhaps as part of a routine physical — could flag those most vulnerable to injury and enable preventive measures before damage occurs.
“That’s been our work for the past 15 years: understanding laxity’s role, how to measure it, and how to intervene” Dr. Schmitz said.
Currently available tools, called arthrometers, are semi-robotic and can cost up to $25,000 each. That price tag, combined with their complexity, means most health care professionals never use them. So, Drs. Schmitz and Shultz set out to innovate something better — a simpler, lower-cost arthrometer that any clinician could use.
A device like that could change everything: allowing quick knee checks, personalized injury-prevention plans, and ultimately saving patients years — even a lifetime — of pain and costly complications.
But translating a lab innovation into a medical product is no small task. “We were really naïve when we started this,” Dr. Schmitz admitted.
They filed their first patent in 2019 and have worked steadily through the challenges that come with research and development. Like many university innovators, they reached what’s often called the “valley of death” — the difficult gap between proof-of-concept and a commercially viable product.
Now, with a patent awarded in April 2025 and support from NCInnovation, they’re moving forward with a phase-one clinical prototype based on a validated lab device. The team now includes a corporate partner to help move the innovation from university research towards commercialization.
“NCInnovation is giving us all sorts of support to make sure the research is successful,” Dr. Schmitz said. “We’re going to have early-phase clinical prototypes ready at the end of this phase.”
NCInnovation also pairs its research funding with commercialization support. In addition to a grant, NCInnovation provides to each project it backs an “entrepreneur-in-residence” – a mentor with an established track record in the private sector who helps guide researchers on the business side of their work. Dr. Amit Sawant is serving as the entrepreneur-in-residence for the project
Dr. Schmitz said, “I’m an academic, not a business person. NCInnovation wants to see this get to the market, and so do we.”
