The ACL ligament is referred to as the anterior cruciate ligament, which is one of the most commonly damaged ligaments of the knee. ACL injuries commonly occur in athletes or people who exercise regularly. ACL surgery can help treat and repair an injured anterior cruciate ligament.
What is the ACL?
The ACL ligament is a strong band of tissue that attaches the end of a bone to the beginning of another. The ACL runs from the back of the thigh bone to the front of the shin bone and passes through a special notch within the femur. This notch is called the intercondylar notch and connects the ACL ligaments to a portion of the tibia known as the tibial spine.
The ACL controls how far the shin bone moves beneath the thigh bone. If the shin bone moves too far, the ACL may tear or rupture due to the strain. When the knee is extended, the ACL is the first ligament that tightens and reduces further motion. Hyperextending the knee beyond this point can lead to an ACL tear.
What treatments are available for a torn ACL?
At Dayton Orthopedic Surgery & Sports Medicine Center, we will only recommend ACL surgery if all other conservative treatment options have been exhausted. Non-surgical treatment options for a torn ACL can include:
- Rest, Ice, Compression and Elevation
- Isolating the affected knee using a splint and crutches, to allow the ligament time to heal on its own
- PRP injections
- Stem cell injections
What types of ACL surgery are available?
Arthroscopic ACL Surgery
The majority of ACL surgeries involve replacing a torn ACL with a graft from another ligament or tendon. This type of ACL surgery is often performed with an arthroscope, which is a small tube with a camera on the end. The internal images of your knee seen through an arthroscope will be displayed on a monitor in the room, offering a live view of your knee. This type of ACL surgery does not require the actual knee joint to be surgically opened. The arthroscope is used to locate the damaged ACL, which will then be repaired. Arthroscopic ACL surgery is less invasive than open knee surgery, so the majority of patients are able to return home the same day as their surgery.
ACL Surgery with Hamstring Graft
A graft from the hamstring may be used to replace the damaged ACL. Hamstring grafts are generally favored because the hamstrings do regenerate with time. Once the damaged ACL is removed, the hamstring graft will be prepared and placed through the tunnel in the femur. The bottom of the graft will be anchored with a bio-absorbable screw, which will slowly be incorporated into the bone with time.
Patellar Graft for ACL
Similar to a hamstring graft, a patellar graft can also be used during ACL surgery. A small tunnel will be made in the upper tibia, which will create an opening where the ACL would attach to the tibia. Another tunnel will be made through the femur where the ACL would attach.
Allograft ACL Reconstruction
During ACL reconstruction, an allograft may be used to replace a damaged tendon. An allograft is tissue that is harvested from another individual. This allograft material may be harvested from the tendon of the tibia, patella, hamstring, or Achilles.
Deciding to have surgery
The decision to have knee surgery will depend on the extent of damage to your ACL and whether it’s affecting your quality of life.
If your knee does not feel unstable and you do not have an active lifestyle, you may decide not to have torn ACL surgery. It’s important to be aware that delaying surgery could cause further damage to your knee.
Risks of ACL surgery
ACL surgery fully restores the functioning of the knee in more than 80% of cases, but your knee may not be exactly like it was before the injury, and you may still have some pain and swelling.
This may be because of other injuries to the knee, such as tears or injuries to the cartilage, which happened at the same time as or after the ACL injury.
As with all types of surgery, there are some small risks associated with knee surgery, including infection, a blood clot, knee pain, and knee weakness and stiffness.
Recovering from surgery
Recovering from a torn ACL surgery usually takes around 6 months, but it could be up to a year before you’re able to return to full training for your sport. It is incredibly important to keep up with your physical therapy, and to not over-exert yourself while healing.