ACL Reconstruction: An Overview
The ACL (anterior cruciate ligament) is the stabilizer of the knee. It is torn easily because of the extent of activity and stress the knee joint is subjected to on a regular basis and the location of the ligament. Each patient must make the choice as to whether or not his or her ACL damage should be treated surgically.
It is based on such factors as how much damage the rest of the knee structure has suffered, the stability of the knee, the patients activity level, and the patients age. If surgery will allow the patient to return to the pre-injury activity level, it is usually recommended.
Surgery acts as a stabilizer to the knee. It also helps prevent secondary damage to the menisci (cartilage cushions) as well as the articular cartilage of the knee. The hope is that surgery will help prevent premature knee deterioration.
Across the board, ACL reconstruction surgery is performed arthroscopically. Personally, I believe that an autograft-tissue graft that comes from the patient is the best thing to use. The alternative is an allograft. This is a graft harvested from a cadaver.
However, I think allografts are subject to problems. Recent research has indicated that patients under age 25 who receive an allograft followed by an aggressive rehabilitation program are 10-25% more likely to have problems.
Click here to learn more about knee arthroscopy.
I prefer to use Patellar Tendon Autograft with interference screw fixation for patients below the age of 30 who have no underlying patellofemoral disease. Additionally, I prefer Hamstring Autograft (semitendinosis and gracilis combined) with a rigid extra-articular fixation - the Rapid Loc or Toggle Loc, for example - on the femur as well as the Washer Loc on the tibia.
If the patient is under age 25, I have been known to use an allograft as long as the patient guarantees he will not engage in aggressive, competitive sports for a full year following the surgery. This period of time gives the allograft a chance to heal. Also, I will use allografts when there is more than one ligament that needs to be reconstructed.
The ACL acts to provide stability for the knee and to keep stress at a minimum across the knee joint:
The ACL prevents an excess of forward movement of the tibia (lower bone of the leg) in relation to the femur (thigh bone).
Excessive knee rotation is also kept under control by the ACL.
Click here to learn more about Dr. Stefan Tarlow, a leading Phoenix Knee Doctor.
The ACL (anterior cruciate ligament) is the stabilizer of the knee. It is torn easily because of the extent of activity and stress the knee joint is subjected to on a regular basis and the location of the ligament. Each patient must make the choice as to whether or not his or her ACL damage should be treated surgically.
It is based on such factors as how much damage the rest of the knee structure has suffered, the stability of the knee, the patients activity level, and the patients age. If surgery will allow the patient to return to the pre-injury activity level, it is usually recommended.
Surgery acts as a stabilizer to the knee. It also helps prevent secondary damage to the menisci (cartilage cushions) as well as the articular cartilage of the knee. The hope is that surgery will help prevent premature knee deterioration.
Across the board, ACL reconstruction surgery is performed arthroscopically. Personally, I believe that an autograft-tissue graft that comes from the patient is the best thing to use. The alternative is an allograft. This is a graft harvested from a cadaver.
However, I think allografts are subject to problems. Recent research has indicated that patients under age 25 who receive an allograft followed by an aggressive rehabilitation program are 10-25% more likely to have problems.
Click here to learn more about knee arthroscopy.
I prefer to use Patellar Tendon Autograft with interference screw fixation for patients below the age of 30 who have no underlying patellofemoral disease. Additionally, I prefer Hamstring Autograft (semitendinosis and gracilis combined) with a rigid extra-articular fixation - the Rapid Loc or Toggle Loc, for example - on the femur as well as the Washer Loc on the tibia.
If the patient is under age 25, I have been known to use an allograft as long as the patient guarantees he will not engage in aggressive, competitive sports for a full year following the surgery. This period of time gives the allograft a chance to heal. Also, I will use allografts when there is more than one ligament that needs to be reconstructed.
The ACL acts to provide stability for the knee and to keep stress at a minimum across the knee joint:
The ACL prevents an excess of forward movement of the tibia (lower bone of the leg) in relation to the femur (thigh bone).
Excessive knee rotation is also kept under control by the ACL.
Click here to learn more about Dr. Stefan Tarlow, a leading Phoenix Knee Doctor.
About the Author:
Dr. Tarlow is a Board Certified Orthopaedic Surgeon with over 20 years specializing in knee surgery. He opened his own clinic, Advanced Knee Care, with a focus on specialty patient care. Click here to learn more about Dr. Tarlow, Phoenix knee surgery and Phoenix-area Knee Arthroscopy.
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