May 6, 2019
By: Dr. Michael O’Malley
The anterior cruciate ligament (ACL) is one of the major stabilizing ligaments in the knee. When torn it does not heal and results in instability of the knee. ACL reconstruction is a common surgical procedure that is now performed arthroscopically with excellent results and low complication rates.
ACL rupture is a common, sports-related injury that is often non-contact in nature, involving a twisting injury to the knee while the leg is planted to the ground. An audible pop is often heard with the sensation that the knee has popped out of joint. Swelling is typically seen very soon following the injury and it is quite rare that the player is able to continue to compete.
The diagnosis is made by way of the patient history, physical exam, and advanced imaging studies. Exam exhibits instability or laxity within the knee. An MRI not only confirms the diagnosis, but also provides insight on the health of the other structures of the knee, such as he cartilage and meniscus.
Treatment options can include both operative and nonoperative intervention. Nonoperative is considered in lower demand patients, that may be able to wear a brace for more strenuous activity when performed. Indications for surgery include athletes, those with an active lifestyle, persistent instability, and those employed in at risk professions.
The surgery is performed arthroscopically utilizing small incisions. Surgical repair can be considered in a certain subset of patients with particular tear patterns. In those requiring reconstruction, graft choice can vary depending on certain patient factors, but typically involves using ones own hamstring or a portion of the patella tendon. Tunnels are made in both the femur and tibia to accept the graft. The graft is secured using either screws or metal buttons, depending on the technique that is used.
Postoperatively, patients are held in a brace for a portion of time while beginning physical therapy. A standardized rehabilitation protocol has been established for each patient. A return to full sport is typically achieved between 6-9 months following surgery.
ACL reconstruction is a common and very successful procedure. It is generally recommended in the patient wishing to return to athletics or those that live an active lifestyle. Our team will guide you through all stages or your care with the goal of a full return back to baseline activity level.