Knee Surgery: Reconstruction of the Anterior Cruciate Ligament
An Overview of ACL Reconstruction
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.
The choice is based on factors such as the extent of damage to the rest of the knee structure, the knees stability, the activity level and age of the patient. If the patient will be able to return to the pre-injury activity level, surgery is usually recommended.
ACL reconstruction can stabilize the knee and prevent further damage to the articular cartilage and the cartilage cushions, known as the menisci. It can also help in preventing premature knee deterioration.
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.
However, I believe these are subject to problems in the long term. Indeed, recent research has shown that patients under the age of 24 who receive an allograft and then participate in an aggressive rehabilitation program are 10-25% more likely to have a high failure rate.
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 acts to provide stability for the knee and to keep stress at a minimum across the knee joint:
Excessive forward movement of the tibia (lower bone of the leg) in relation to the femur (thigh bone) is also prevented by the ACL.
Excessive rotational motion of the knee is also kept under control by the ACL.
Click here to learn more about Dr. Stefan Tarlow, a leading Phoenix Knee Doctor. - 17268
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.
The choice is based on factors such as the extent of damage to the rest of the knee structure, the knees stability, the activity level and age of the patient. If the patient will be able to return to the pre-injury activity level, surgery is usually recommended.
ACL reconstruction can stabilize the knee and prevent further damage to the articular cartilage and the cartilage cushions, known as the menisci. It can also help in preventing premature knee deterioration.
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.
However, I believe these are subject to problems in the long term. Indeed, recent research has shown that patients under the age of 24 who receive an allograft and then participate in an aggressive rehabilitation program are 10-25% more likely to have a high failure rate.
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 acts to provide stability for the knee and to keep stress at a minimum across the knee joint:
Excessive forward movement of the tibia (lower bone of the leg) in relation to the femur (thigh bone) is also prevented by the ACL.
Excessive rotational motion of the knee is also kept under control by the ACL.
Click here to learn more about Dr. Stefan Tarlow, a leading Phoenix Knee Doctor. - 17268
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 surgeons and Phoenix-area Knee Arthroscopy.
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6:36 AM
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