The Facts About ACL (anterior cruciate ligament) Reconstruction

By Dr. Richard Edelson

When you tear the anterior cruciate ligament in your knee, your doctor will probably recommend ACL (anterior cruciate ligament) Reconstruction surgery. When this is the case, it is important that you understand that the tissue to be used in your surgery can come from a variety of sources.

Autograft is the term used to describe a graft that is taken from your body. An autograft is usually taken from part of the tendon that is located on the front of your knee. This is called the patellar tendon. Another place an autograft may be taken is the hamstring.

You may also receive tissue that has been taken from a cadaver (dead person). This is called an allograft.

Both options have positive and negative aspects. Your surgeon will review these with you and work with you to decide which option suit you.

ACL (anterior cruciate ligament) Reconstruction surgery is normally performed with the use of an arthroscope. To perform knee arthroscopy, your surgeon will create a small poke-hole in your knee and insert a tiny camera. This camera is connected to a video monitor and allows your surgeon to see the inside of your knee.

Your surgeon will examine the ligaments and the cartilage in your knee. If he or she finds that there has been other damage (for example, a meniscus tear) it will be taken care of during your surgery.

Several types of anesthesia are used for arthroscopic knee surgery, but you will probably receive general anesthetic. This will allow you to sleep during the surgery. While you are sleeping, your surgeon will replace your ACL (anterior cruciate ligament).

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Small incisions will be made around your knee so that your surgeon can get your new ligaments into just the right places. A bone shaver or other instrument will be used to remove your damaged ligament. If you will be using your own tissues to replace the damaged tissues, your surgeon will make a larger incision in order to access it.

Your surgeon will create bone tunnels that will allow the new ligament to be placed in exactly the same position as the old ligaments. Screws or other surgical fasteners will be used to secure the ligaments into their proper positions. When the surgery is done, your surgeon will place a dressing on your knee.

One advantage of arthroscopy is that your surgeon can create a complete and accurate video record of the procedure and review it with you afterwards. You will be able to watch the surgery on a video monitor and talk with the surgeon about any questions or concerns you may have.

If you have unstable knees, pain in your knees, or your knee gives out on you unexpectedly, you may be referred for ACL (anterior cruciate ligament) reconstruction. Additionally, if you are simply unable to play sports and/or participate in ADL (activities of daily living), ACL (anterior cruciate ligament) reconstruction may be the answer for you.

Complications are rare with this type of surgery; however, they do exist. Some things to keep in mind are the possibility of: Failure to heal, failure to relieve symptoms, stiffness and pain in the knees, continued weakness in the knees, infection at the site of the surgery, nerve damage, and bleeding.

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