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Sunday, September 20, 2009

Options for the Treatment of ACL Injury

By Dr. Richard Edelson

Joints are held together with ligaments. Sometimes a ligament can tear causing a great deal of pain. The anterior cruciate ligament is located at the center of your knee. It prevents your tibia (shin bone) from moving forward onto your femur (thigh bone).

If you tear your ACL, your knee may give out while you are engaged in physical activity. If you dont have this treated, your knee may give out time and again. This can cause early arthritis as well as damage to the cartilage.

Fortunately, damaged ligaments can be replaced. ACL reconstructive surgery replaces your old anterior cruciate ligament with a new one. This new ligament could come from you (autograft) or from a cadaver (allograft).

If you use an autograft, it will probably be taken from the front of your knee. This is called the patellar tendon. It may also come from your hamstring.

There are pros and cons to both types of grafts; however, both are usually successful for most people. Talk with your surgeon to find out more.

Click here for more on ACL tear surgery.

Arthroscopy is the procedure that is usually used for ACL reconstruction. Although this type of surgery can be done using a variety of types of anesthesia, you will probably receive general anesthesia. This will let you sleep through the whole thing.

Arthroscopy is conducted with the assistance of a small camera inserted into a joint. Your surgeon will make a small incision called a poke-hole to insert the camera. Then the surgeon can get a clear view of the inside of your knee on a video monitor. This will allow your surgeon to check the condition of all of the structures of the knee. If your surgeon discovers damage in addition to your ACL tear, he or she will go ahead and fix the problem.

If you are using an autograft, there will be one large incision (also called an open incision) made to remove this tissue. Additionally, your surgeon will access the areas to be worked on via several small incisions around the knee. These will be used to place your new ligament. Your old ligament will be removed, then the surgeon will make bone tunnels to place the new ligament in the same position as the old one. The new ligament will be secured with surgical fasteners such as screws.

Once the surgery is complete, your incisions will be cared for and your knee will be dressed. You will wake up from the anesthesia, and watch a movie of your knee surgery with your surgeon. At this time, your surgeon can share the findings with you, and you can ask any questions you may have. - 17268

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