Definition
 Anterior cruciate ligament reconstruction surgery replaces the ACL ligament
with a new ligament to improve stability and to decrease the chances of having
cartilage injuries.
Alternative Names
Who is a Candidate?
People who have knees that:
- Are unstable
- Tend to give away during activities
- Make them incapable of playing sports
What is Anterior Cruciate Ligament Reconstruction Surgery?
The ACL is a ligament in the center of the knee that prevents the shin bone
(tibia) from moving forward on the femur (thigh bone). A tear of this ligament
can cause the knee to give way during physical activity. If a torn ACL is left
untreated, cartilage damage and early arthritis may occur.
ACL reconstruction is surgery to replace the torn ligament. There are several
choices of tissue to use for the new ligament, including an autograft (tissue
from the patient's own body) or an allograft (tissue from a donor). The most
common autografts use part of the patellar tendon (the tendon in the front of
the knee) or use the hamstring tendons.
The procedure is usually performed by having a camera inserted into the knee,
which is known as knee arthroscopy. The camera is connected to a video monitor.
The surgeon evaluates the cartilage and ligaments of the knee by viewing the
monitor.
Additional small incisions are made around the knee to put the new ligament in
place. The old ligament will be removed using a shaver. Bone tunnels will be
made to place the new ligament in the knee at the site of the old ACL. If the
patient's own tissue is to be used for the new ligament, a larger incision will
be made to take the tissue. The new ligament is then fixed to the bone using
screws or other devices. At the end of the surgery, the incisions are closed and
a bandage is applied.
Rehabilitation/Recovery
One of the main priorities after ACL reconstruction is to regain the knees
range of motion. Establishing a good strengthening program is vital for a
successful recovery. Crutches are usually needed for at least a week or two,
with gradual progression to one crutch and finally to independent walking. Some
surgeons prescribe a rehabilitation brace that is adjustable and can be locked
in a straight position or set to allow a certain amount of movement.
A tear of the ACL used to be a career-ending injury for many athletes, but
improvements in the surgery and in rehabilitation have lead patients back to
their desired activities. These improvements have resulted in less pain and
stiffness, fewer complications, and faster recovery time.
To learn more about ACL reconstruction, visit the
Knee Patient Education section of orthorogerson.com.
2/2/2009
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