University of Oxford

ACL STARR Study

Anterior Cruciate Ligament Stratified Accelerated Repair.

The ACL STARR Study compares two surgical approaches for treating a torn anterior cruciate ligament (ACL).

The ACL is a key ligament that stabilises the knee and is commonly injured during sport or physical activity. ACL injuries can lead to long-term knee instability and increase the risk of developing osteoarthritis later in life.

The study is investigating whether repairing the existing ligament provides better outcomes than ACL reconstruction, the standard procedure where the ligament is replaced with tissue taken from elsewhere in the body.

Morph solution

Morph supported the ACL STARR Study by developing digital tools to help explain the trial and support communication with potential participants.

Patient Information Animation – a 2D explainer outlining what participation in the study involved, helping people quickly understand the purpose and process.
Participant Information Tool (PIT) – an interactive digital version of the patient information sheet, guiding participants step by step through key details to support understanding and informed consent.
Study Website – a professional public-facing hub bringing all trial information together in one accessible place. The animation appears on the homepage and at the start of the Participant Information Tool, providing a clear and consistent introduction for participants.

The ACL STARR Study video

The ACL STARR study is investigating which is the best surgical option for people who have torn their anterior cruciate ligament, or ACL.

The ACL is an important band of tissue that supports the knee. It is a strong structure in the centre of the knee. It attaches the thigh bone to the shin bone.

ACL injuries can be treated with surgery or rehabilitation physiotherapy. You will decide with your surgeon and family or carers which is more suitable for you.

If you choose surgery, you may be eligible for this study.

The ACL STARR study will compare two types of surgery to see which is better. A reconstruction, where the torn ligament is replaced using tissue from elsewhere in your body, or a repair, which means that your torn ligament is kept and repaired. Both are already performed in the NHS.

If you decide to join the study, we will ask you to sign a consent form and to complete a set of questions about your knee injury.

At the start of your operation, your surgeon will look at your ligament to make sure it is suitable for either surgery. If repair surgery isn't suitable, you will have reconstruction surgery. You will not be part of the study and will be looked after as normal.

If it is suitable, your type of surgery will be decided randomly by a computer. Half of our participants will have reconstruction surgery and half will have repair surgery.

We won't tell you which surgery you've had until after the study has finished.

After surgery, you will have physiotherapy to help your recovery.

At three and six weeks after surgery, we will ask you to complete a pain score. This is a number on a scale from zero to ten, sent by text, email, or post, depending on your choice.

At six, twelve and twenty-four months after your operation, we will send you a set of questions by email or by post. We want to find out how well you function, walk, run, or play sport two years after surgery.

It will only take ten minutes to complete each set of questions.

Taking part is voluntary and you can leave at any time.

By taking part, you'll help us find out which surgery is best for treating torn ACLs.

The doctors, surgeons and research team are happy to answer any questions about joining the study.

Our collaboration with Morph over the production of the ACL animation was a terrific journey in so many ways. The team were approachable, listened to and acted on the brief - and then used their experience to generate a meaningful and engaging patient aid. We ended up with a first class animation of high relevance to the target audience of ACL injured patients. They even generously adjusted the "already built" animation to suit an Australian audience for the mirror trial down under. Thank you Morph

Professor David Beard, University of Sydney