ACL Reconstruction

The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope-like structure located in the center of the knee running from the femur to the tibia. Unfortunately, when this ligament tears; it does not heal and often leads to a feeling of instability in the knee.

ACL reconstruction is a commonly performed surgical procedure and with recent advances in arthroscopic surgery can now be performed with minimal incision and low complication rates.

Anterior cruciate ligament reconstruction hamstring method

Anterior cruciate ligament reconstruction hamstring method is a surgical procedure to replace the torn ACL with part of the hamstring tendon taken from your own leg. The hamstring is the muscle located on the back of your thigh. The procedure is performed under general anesthesia. Your surgeon will make two small cuts, about 1/4-inch-long, around your knee. An arthroscope, a tube with a small video camera on the end, is inserted through one incision to view the inside of the knee joint. Along with the arthroscope, a sterile solution is pumped into the joint to expand it, enabling your surgeon to have a clear view and space to work inside the joint.

The knee is bent at right angles and the hamstring tendons felt. A small incision is made over the hamstring tendon attachment to the tibia and the two tendons are stripped off the muscle and the graft is prepared. The torn ACL will be removed and the pathway for the new ACL is prepared. The arthroscope is reinserted into the knee joint through one of the small incisions. Small holes are drilled into the upper and lower leg bones where these bones come together at the knee joint. The holes form tunnels in your bone to accept the new graft. The graft is pulled through the predrilled holes in the tibia and femur. The new tendon is then fixed into the bone with screws to hold it in place while the ligament heals into the bone. The incisions are then closed with sutures and a dressing is placed.

Anterior cruciate ligament reconstruction patellar tendon

The anterior cruciate ligament reconstruction patellar tendon is a surgical procedure to replace the torn ACL with part of the patellar tendon taken from your own leg. The new ACL is harvested from the patellar tendon that connects the bottom of the kneecap (patella) to the top of the shinbone (tibia). The procedure is performed under general anesthesia. Your surgeon will make two small cuts about ΒΌ inch around your knee. An arthroscope, a tube with a small video camera on the end is inserted through one incision to view the inside of the knee joint. Along with the arthroscope, a sterile solution is pumped into the knee to expand it, providing your surgeon to have a clear view of the inside of the joint.

The torn ACL will be removed and the pathway for the new ACL is prepared. Your surgeon makes an incision over the patellar tendon and takes out the middle third of the patellar tendon, along with small plugs of bone where it is attached to each end. The remaining portions of the patellar tendon on either side of the graft are sutured back after its removal. Then, the incision is closed. The arthroscope is reinserted into the knee joint through one of the small incisions. Small holes are drilled into the upper and lower leg bones where these bones come together at the knee joint. The holes form tunnels in your bone to accept the new graft. The graft is pulled through the predrilled holes in the tibia and femur. The new tendon is then fixed into the bone with screws to hold it in place while the ligament heals into the bone. The incisions are then closed with sutures and a dressing is placed.

Risks and complications

The possible risks and complications associated with ACL reconstruction with the hamstring and patellar tendon methods include:

  • Numbness
  • Infection
  • Blood clots (deep vein thrombosis)
  • Nerve and blood vessel damage
  • Failure of the graft
  • Loosening of the graft
  • Decreased range of motion
  • Crepitus (crackling or grating feeling of the kneecap)
  • Pain in the knee
  • Repeat injury to the graft

Postoperative care

Following the surgery, rehabilitation begins immediately. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement. Avoid competitive sports for 5 to 6 months to allow the new graft to incorporate into the knee joint.