ACLreconstruction is a common knee surgery among athletes and active people. It is estimated that several hundred thousand are performed each year in the United States.
increased sports participation,
especially at the high school and collegiate levels, ACL knee injury
has become commonplace among athletes.
While many knee injuries can be treated conservatively, ACL tears often must be treated surgically. The ACL is a complicated and extremely important structure in the knee. Its absence causes great loss of function. It is widely accepted that it is necessary to reconstruct the ACL in younger, atcive people, to help preserve the long term health of the knee.
Lets look closer at this knee surgery, the ACL reconstruction.
put, an ACL reconstruction seeks
to replace your damaged ACL with another similiar type of tissue.
Reconstructing it means that it must be placed in the same position as
your original ACL, and that the tissue used must have similiar
properties to the ligament that was torn.
It is important to realize that a reconstruction, when talking in surgical terms, is different from a repair. A repair means that the original tissue is somewhat still intact, and that it is mended in some way to return it to a working order. While many ligaments in the body can be repaired (such as in the shoulder), the ACL cannot. Primary repair of the ACL has long been abandoned as a failing procedure.
The construction of the new ACL must be as
close to the original as possible. There are many different types of
tissues in the body that can be used for an ACL graft. The two most
common are the patellar tendon
and the hamstring tendon.
ACL surgery has been performed with other grafts as well, but
by far, the majority of surgeries performed use one of these two
tendons. The graft tissue can come from your own body, or may come from
a cadaver. Cadaver grafts are called allografts, while your own tissue
is called an autograft.
Each has its own unique strengths and weaknesses. Most physicians will specialize in one type of graft use or the other. It comes down to their own philosophies, success, and training on which graft choice they prefer.
I would encourage you to discuss with your physician the graft that will be used for your ACL reconstruction, and make sure that you are aware of the strengths and weaknesses of each tissue type.
ACL reconstruction usually begins with a knee
arthroscopy. You are placed under general anesthesia, and the physician
places the arthroscope into your knee. They will use two portals, one
on each side of the knee. One portal contains a camera, the other the
tools to work with.
The arthroscopy gives the physician the ability to look inside of your knee, and to see exactly what is going on, and what is damaged. They will explore your knee, and will look for the following:
I treat ACL surgery patients daily. They all have lots of questions. I
have provided information based on all of their different
Choosing a Physician For Your ACL Surgery
Not all orthopedists are created equal. Do you know what to look for in a good surgeon for your ACL surgery?
ACLR: Questions for Your Physician
Your orthopedic surgeion is the best person to answer your questions about ACL surgery. Here is a list of questions to get you started...
Graft Choices: Patellar Tendon
Learn about the benefits and drawbacks of this graft type, and how it plays into the reconstruction and rehab.
Graft Choices: Hamstring Tendon
Is the hamstring tendon graft a good choice for you? Read more about this tissue type, why it is used, and how it affects your rehab.
ACLR: Pre Surgical Exercises
A good start to pre-surgical ACL exercises to help you prepare for surgery.
ACLR: What to Expect
How much does it hurt? What will my knee feel like? What on earth is all of this yellow stuff? These questions and more are answered here.
ACLR: The First Week
The first week after surgery is important to get yourself started out on the right foot. Learn about what you can do to maximize your recovery.
ACLR Rehab: Regaining Range of Motion
Regaining motion after surgery is very important. Here are a few ways you can work to improve your motion.
ACLR Rehab: Regaining Strength (Coming Soon)
ACLR Rehab: Restoring Normal Gait (Coming Soon)
ACL Recovery Timeline
How long will you be on crutches? How long do you have to wear a brace? When can you run again? Read through my ACL timeline and learn more about what lies ahead.
ACL Surgery Stories
If you have had an ACL reconstruction, or are getting ready for this surgery, I want to hear your story. Whether you have questions you want answered, or just want to share your experience, this is the place for you.