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The anterior cruciate ligament, or ACL, is one of four major ligaments that make up the knee. Ligaments are in place to stabilize the femur (thigh bone), which sits just above the tibia (shin bone). The ACL is important for maintaining knee stability. ACL injuries are very common among athletes.
Symptoms of an ACL Injury
- Patients with an ACL tear often report instability in the knee
- Feeling as if it will “give out”, or pop out of place
Degrees of an ACL Injury
- Grade I Injury: Minor stretching of the ligament. Patients will feel swelling and tenderness but will be able to resume normal activities
- Grade II Injury: This injury represents a partially torn ACL (usually one of the two bundles). Walking for patients is usually more difficult. Surgery may be recommended.
- Grade III Injury: This injury occurs when the ACL is torn completely. Patients usually have severe pain; inflammation and swelling.
ACL Surgery Technique
An ACL surgery requires precise knowledge of the anatomy of the knee, attachment sites of the ACL.
The most important point that leads to failure of graft is the incorrect placement of reconstruction tunnels.
The technique of ACL reconstructions has changed dramatically over the last decade in orthopedics.
Our primary surgical reconstruction technique involves using a hamstring autograft (from the patient’s own tissues) during ACL surgery. The reconstruction tunnel is drilled at the anatomic attachment site of the ACL on the tibia and femur. The graft is pulled into the joint and fixed in place with tightrope and peek screws. As we do all the reconstruction arthroscopically this results in less pain post-operatively for the patient and the use of the autograft allows the patient to return to activities sooner with a lesser risk of reconstruction graft failure.
Post-Operative Protocol
Good physical therapy is paramount in success of ACL reconstruction. The patient is allowed to walk full weight bearing from next day. Knee rom exercises are started within 24 hrs. Our aim is to achieve full knee bending in 3 weeks followed by strength training so that the patient can return to sport as soon as possible Most of our patients go back to sport in 3-5 months.
If left untreated?
ACL injury can lead to injury of other associated structures in the knee like menisci and cartilage.