The ACL (anterior cruciate ligament) is one of the four major ligaments in the knee joint that helps to provide stability and support to the knee during movement. It is responsible for preventing excessive forward movement of the tibia in relation to the femur, as well as rotational movements of the knee joint. It also helps to keep the knee joint stable during side-to-side movements.
Injuries to the ACL are common especially in sports that involve sudden stops, changes in direction and twisting of the knee. When the ACL is torn or ruptured it leads to knee instability and increases the risk of damage to other knee structures. The ACL cannot heal itself.
ACL reconstruction is the surgical procedure to replace a torn or damaged ACL. The goal is to restore knee stability and function so that the patient can return to daily life activities such as walking and climbing stairs and sports without pain and instability.
Before surgery, a patient usually undergoes physical therapy, because if the patient has a stiff, swollen knee and poor range of motion at the time of surgery, it can create major problems in regaining motion after surgery.
ACL (anterior cruciate ligament) reconstruction is usually performed arthroscopically. Arthroscopic surgery is a minimally invasive surgical technique that allows the surgeon to view and operate on the inside of the joint using a small camera called an arthroscope. The camera is inserted through a small incision in the skin and provides a clear view of the joint on a monitor. Then small surgical instruments are inserted into the knee to perform the surgery.
Arthroscopic ACL reconstruction has several advantages over traditional open surgery. It allows for smaller incisions, less soft tissue disruption, less post-operative pain, and faster recovery times. Additionally, the arthroscopic approach allows for a more precise surgical technique and can result in better outcomes.
Under anesthesia, the surgeon makes small incisions in the knee to access the joint. A small camera, called an arthroscope, is inserted into one of the incisions to provide the surgeon with a clear view of the inside of the knee. Then they can verify the tear and diagnose all other damaged tissues, such as other knee ligaments and the meniscus. ACL tears are frequently associated with injury to the to the meniscus, damage to the articular cartilage.
During surgery the surgeon will remove the damaged ACL and harvest a graft of tissue from the patient’s own body or from a donor. The most common sources of graft tissue are the patellar tendon, hamstring tendons, or cadaveric tissue.
The harvested graft tissue is prepared to the appropriate size and shape for ACL reconstruction. Then the surgeon prepares the bones to accommodate the graft and inserts the graft securing it with screws and other devices.
If the meniscus is damaged, the surgeon will perform a repair. If the articular cartilage is damaged, they may perform a microfracture. Using special instruments, they will trim the loose cartilage and created microfractures in the bone to stimulate the formation of new cartilage.
When all repairs are complete, they will close the incisions with sutures or surgical staples.
Post-operative rehabilitation is a vital aspect of recovery after ACL reconstruction surgery. It involves a structured program of exercise and physical therapy designed to help patients regain strength, range of motion and stability. It usually begins within a few days after surgery and can last several months Patients who follow the program carefully are more likely to regain full knee function and resume normal activities.
ACL reconstruction is a complex surgical procedure, and the specifics of the surgery can vary depending on the individual case and the surgeon’s preferred techniques. Recovery times vary depending on the individual and the extent of the injury, but most patients can expect to return to normal activities within six to twelve months after surgery.
Success is typically defined as the ability to return to pre-injury activities, such as sports or exercise, without pain or instability. The success rate of ACL (anterior cruciate ligament) reconstruction varies depending on several factors, including the patient’s age, activity level, and the extent of the injury. However, the overall success rate of ACL reconstruction is generally high.
When you or a loved one suffers with a knee injury that affect stability and function, contact LALL Orthopedics + for world-class care, close to home. We have offices in Belvidere, Illinois, Paramus, New Jersey and Philadelphia, PA.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in diagnosing and treating knee injuries. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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