Anterior Cruciate Ligament (ACL) Tear

A tear of the anterior cruciate ligament is most often seen after a sports injury, in which a major twisting or strain injury has occurred. There is usually a painful pop, followed quickly by swelling in the knee.

Although it is possible for some to walk, run, and even participate in demanding sports after a torn ACL, many patients are bothered by recurrent episodes of "giving way" and instability, which may warrant surgical treatment.

Direct repair of the ACL is not usually technically successful, because of the poor healing and high stresses on the ligament. Therefore, when surgical treatment is chosen, the ligament is reconstructed with tissue taken as a graft from elsewhere about the knee. Most commonly, part of the hamstring tendons or patellar tendon (a large tendon attached the kneecap) is used as graft material.

The graft is placed at the location of the torn ACL, and is attached to bone by absorbable screws. Most of the procedure is carried out through small incisions using the arthroscope, with an additional 1-2 inch incision to obtain the graft.

Arthroscopic ACL reconstruction is often done as an outpatient, though sometimes an overnight hospital stay may be needed. The knee is protected in a brace for about 6 weeks after ACL reconstruction, but some weight bearing can be started soon after surgery. Return to unlimited sports activity should be delayed for several months, however, as the reconstructed ligament requires at least 6 to 9 months to mature and reach its maximum resistance to reinjury.
Arthroscopic ACL Incisions Arthroscopic ACL Reconstruction