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.
ACL reconstruction will stabilize the knee. This prevents further damage to the articular cartilage and the menisci (cartilage cushions). Surgery helps in preventing premature deterioration of the knee.
Without exception, ACL reconstruction is performed arthroscopically. I personally prefer to use an autograft-tissue graft. Autograft is a graft harvested from the patient. An allograft, which is harvested from a cadaver is another possibility.
I think that using the patients own tissue results in a more successful reconstruction that yields better long term results. Specifically, I believe that by using the patients own tissue, ACL re-injury rates are lowered. Interestingly, there have been two scientific studies conducted in the past few years that indicate a high failure rate - ten to twenty-five percent - if a young patient (under 25) receives allograft tissue and also participates in an aggressive program of rehabilitation.
Click here to learn more about knee arthroscopy.
My preference is to use a Patellar Tendon Autograft combined with interference screw fixation when dealing with patients under thirty years of age who do not have any underlying patellofemoral disease. I also prefer Hamstring Autograft (semitendinosis and gracilis combined) using rigid extra-articular fixation (Rapid Loc or Toggle Loc) on the femur along with a Washer Loc on the tibia.
If my patient is under the age of 25, I am willing to use an allograft only if the patient will avoid aggressive and competitive sports for a complete year. This will allow the allograft enough time for healing. Additionally, I am willing to use allografts if I am reconstructing more than one ligament.
The ACL keeps the knee stabilized and stress at a minimum across the knee joint.
In addition, excessive forward movement of the lower bone of the leg (tibia) in relation to the thigh bone (femur) is prevented by the ACL.
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.
ACL reconstruction will stabilize the knee. This prevents further damage to the articular cartilage and the menisci (cartilage cushions). Surgery helps in preventing premature deterioration of the knee.
Without exception, ACL reconstruction is performed arthroscopically. I personally prefer to use an autograft-tissue graft. Autograft is a graft harvested from the patient. An allograft, which is harvested from a cadaver is another possibility.
I think that using the patients own tissue results in a more successful reconstruction that yields better long term results. Specifically, I believe that by using the patients own tissue, ACL re-injury rates are lowered. Interestingly, there have been two scientific studies conducted in the past few years that indicate a high failure rate - ten to twenty-five percent - if a young patient (under 25) receives allograft tissue and also participates in an aggressive program of rehabilitation.
Click here to learn more about knee arthroscopy.
My preference is to use a Patellar Tendon Autograft combined with interference screw fixation when dealing with patients under thirty years of age who do not have any underlying patellofemoral disease. I also prefer Hamstring Autograft (semitendinosis and gracilis combined) using rigid extra-articular fixation (Rapid Loc or Toggle Loc) on the femur along with a Washer Loc on the tibia.
If my patient is under the age of 25, I am willing to use an allograft only if the patient will avoid aggressive and competitive sports for a complete year. This will allow the allograft enough time for healing. Additionally, I am willing to use allografts if I am reconstructing more than one ligament.
The ACL keeps the knee stabilized and stress at a minimum across the knee joint.
In addition, excessive forward movement of the lower bone of the leg (tibia) in relation to the thigh bone (femur) is prevented by the ACL.
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 more than 20 years experience focusing on knee surgery. After 19 years of practice, he opened his own clinic, Advanced Knee Care, in Phoenix, Arizona. Click here to learn more about Dr. Tarlow, Phoenix knee surgery and Phoenix ACL Reconstruction.
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