The ACL is one of the four ligaments in the knee that connects the femur(thigh bone) to the tibia (shin bone). The ACL plays an important role in knee stability and function as it prevents the tibia from sliding too far forward and causing the knee to be unstable and dislocate.
In most cases, when the ACL is torn, arthroscopic surgery is performed. Generally speaking, an orthopedic surgeon reconstructs a torn ACL in the following manner:
- The tear is examined. A healthy ACL is taught with very little laxity. In contrast, a torn ACL is loose and is easily moveable. The kneecap may also be able to moved out of place which is a sign of an ACCL tear. When arthroscopically examining a torn ACL, an orthopedic surgeon uses a small metal instrument called a probe.
Illustration 1- The ligaments of the knee. A normal ACL is a taught “rope” that provides stability.
- The torn ACL is removed. In order for the ACL to be reconstructed, torn or damaged portions of the ACL need to be trimmed or removed. This goal is accomplished by the use of a tiny shaving device.
- The tissue graft is harvested and prepared. The tissue graft is harvested and prepared. Usually, hamstring tendons from the patient’s own body are used to replace the torn ACL. In some circumstances, a portion of the patella tendon is harvested. Alternatively, a cadaver tendon from a tissue bank can be used.
- The tissue graft is passed through the tibia and femur. Small holes are drilled into the tibia and femur. Through these holes, the tissue graft is passed and then secured—acting as a new, taught structure that improves joint stability and allows for ligamentous growth/reattachment.
Illustration 2- The tissue graft is passed through the tibia and femur
The procedure usually takes 1-2 hours depending on the severity of the tear and the presence/absence of a meniscus tear. Patients are usually sent home shortly after the procedure. Physical therapy can be started as early as the week of surgery or after the two-week mark. After adhering to the advice and treatment of their surgeon and physical therapist, patients can expect to return to competition/activity in six or more months.
Contacting an Orthopedic Surgeon
Patients who have torn their ACL, or injured their knee, are advised to arrange an appointment with one of our orthopedic specialists in Duxbury or Sandwich, MA. Once an accurate diagnosis has been made, a treatment plan will be decided upon. If surgery is necessary, know that you’ll be in great hands and can expect a full recovery.
At Plymouth Bay Orthopedic Associates, our team consists of Fellowship-Trained and Board Certified Orthopedics and Sports Medicine Specialists that have extensive experience treating knee injuries. We offer a full spectrum of treatment options that include conservative treatment and Physical Therapy to the latest advancements in arthroscopic surgery and tendon repair.