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ACL reconstruction

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ACL reconstruction

Definition:

ACL reconstruction is surgery to replace the ligament in the center of the knee (the anterior cruciate ligament, or ACL) with a new ligament.

Description:

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The purpose of a ligament is to hold two bones together. The ACL is a ligament in the center of your knee that prevents the shin bone (tibia) from moving forward on the femur (thigh bone). A tear of this ligament can cause your knee to give way during physical activity. Recent research suggests that if a torn ACL is left untreated, and the knee repeatedly gives way, 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 cadaver). The most common autografts use part of the patellar tendon (the tendon in the front of the knee) or use the hamstring tendons. Each type of graft has small advantages and disadvantages, and work well for many people.

The procedure is usually performed by knee arthroscopy. With arthroscopy, a camera is inserted into the knee through a small poke-hole. The camera is connected to a video monitor. The surgeon evaluates the cartilage and ligaments of the knee. If there is other damage, such as a meniscus tear, the surgeon will fix the problem. Most patients go to sleep for the procedure, but it can be performed under different types of anesthesia.

Then, the surgeon will replace the ACL. Additional small incisions are made around the knee to place the new ligament. The old ligament will be removed using a shaver or other instruments. 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, "open" incision will be made to take the tissue. The new ligament is then fixed to the bone using screws or other devices to hold the ligament in place.

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