ACL Repair (Anterior Cruciate Ligament)
Contact Dr. Max Greig
Email: orthopedicdoctormx@gmail.com
Common injuries
One of the most common knee injuries is an anterior cruciate ligament (ACL) sprain, or tear.
Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their ACL.
If you have injured your ACL, you may require surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level.
Description
About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.
Injured ligaments are considered sprains and are graded on a severity scale.
Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 sprain. It has been slightly stretched but is still able to help keep the knee joint stable.
Grade 2 Sprains. A Grade 2 sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.
Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been torn in half or pulled directly off the bone, and the knee joint is unstable.
Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.
Cause. The anterior cruciate ligament can be injured in several ways:
- Changing direction rapidly
- Stopping suddenly
- Slowing down while running
- Landing from a jump incorrectly
- Direct contact or collision, such as a football tackle
Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control.
Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.
Symptoms
When you injure your anterior cruciate ligament, you might hear a popping noise and you may feel your knee give out from under you. Other typical symptoms include:
- Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may go away on its own. However, if you attempt to return to sports, your knee will probably be unstable, and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
- Loss of full range of motion
- Tenderness along the joint line
- Discomfort while walking
Surgical Treatments
ACL tears are not usually repaired using suture to sew it back together, because repaired ACLs have generally been shown to fail over time. Therefore, a substitute graft made of tendon generally replaces the torn ACL. The grafts commonly used to replace the ACL include:
- Hamstring tendon autograft (autograft comes from the patient)
- Quadriceps tendon autograft
- Allograft (taken from a cadaver) patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon
The goal of the ACL reconstruction surgery is to prevent instability and restore the function of the torn ligament, creating a stable knee. This allows the patient to return to sports.
ACL Common Treatment Options
Meniscus Removal or Repair
Your surgeon may remove or repair damaged meniscal tissue. Torn tissue on the inside of the blood to heal properly.meniscus is often removed. Newly torn tissue on the outer edge of the meniscus can often be repaired. This tissue gets enough
Ligament Reconstruction
Your surgeon can reconstruct a damaged anterior cruciate ligament. The damage tissue is replaced with healthy, strong tissue (a graft). The graft may come from the patellar ligament or from another source.
Cartilage Shaving or Removal
Your surgeon may smooth or shrink rough cartilage by shaving it or using a thermal device. Or, your surgeon may drill exposed bone to make the cartilage grow. Any loose bodies may be removed.
Patella Smoothing or Release
Your surgeon may smooth or shrink bands of cartilage under the patella by shaving them or using a thermal device. If the patella is tilted, your surgeon may clip bands of tissue. This is called a lateral release. It aligns the patella with the femur.