Anterior Cruciate Ligament (ACL)
Reconstruction
Anterior Cruciate Ligament (ACL) reconstruction surgery creates a new ligament inside your knee to replace the torn ACL. This restores stability to the knee joint. ACL tears typically occur:
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High risk groups:
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Non contact tears occur when the foot is planted with a flexed knee and the person makes a sudden change in direction. Cutting, twisting, pivoting and jumping (landing unpredictably) are common ways tearing the ACL without involving another person. Back to Top |
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Those who have been diagnosed with an ACL tear have described a loud pop. They also feel that the injury was major and generally cannot continue their activity or sport. Ask a Clarian Expert features Dr Shelbourne's answers to questions about ACL injuries. Back to Top |
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Graft Choice |
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The Shelbourne Knee Center at Methodist Hospital uses a section of patellar tendon to reconstruct the torn or missing ACL. We also take the patellar tendon from the other, normal knee, this surgery is known as a contralateral acl reconstruction. |
| We choose the patellar tendon over other grafts because it is the strongest tendon in the body and offers the shortest rehabilitation time. It has bone on each end which grows into the bone it is attached to. The site the graft is taken from grows back and fills in back to normal. |  |
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Arthroscopy |
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| ACL reconstruction begins with an arthroscopy (scope). This procedure is used to examine the knee joint and look for meniscal and/or bone surface damage. These injuries are treated at this time. |  |
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Remove ACL and Clean Notch |
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| Following the scope, ACL reconstruction begins with a 6-7cm incision in the front of the knee. After exposing the knee joint, the damaged ACL is removed and the surrounding area (notch) is cleaned to make room for the new ACL. | |
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Tunnels for Graft |
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| Tunnels* are drilled independently through the tibia and femur so the graft can be placed. *Tunnel placements illustrated are approx locations | |
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New ACL |
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The new ACL is a graft obtained from the patellar tendon. The graft can be taken from the other normal knee. This called a contralateral graft. Or the graft can be take from the knee with the torn ACL. This graft is known as an ipsilateral graft. The graft is removed with bone (bone plugs) from the knee cap (patella) and the shin (tibia) at both ends. |
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Inserting the New ACL |
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| Each of the bony ends are inserted into the tunnels and the graft is pulled into place. Sutures are attached to the bone plugs and then tied over buttons to hold the graft in place. A light dressing is applied and the patient is taken to a private room. |  |
Before being dismissed from the hospital, the postoperative rehabilitation program is outlined and demonstrated for both the patient and family.Return to Top |
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