An anterior cruciate ligament (ACL) injury is caused by the extreme stretching and tearing of the anterior cruciate ligament of the knee, usually due to a sport or fitness related activity.

 

The ACL is located in the knee joint and connects the front top of the tibia (the lower leg bone) to the rear bottom of the femur (the thigh bone). The torn ACL cannot be repaired by simply sewing it together, it must be reconstructed by substituting a new ligament for the damaged ligament. The most common procedure to replace the damaged ligament is to use part of the patella tendon or the hamstring muscle tendon.

 

The ACL reconstruction is normally done arthroscopically, which is a minimally invasive procedure using smaller incisions than open surgery, and can restore motion to the knee with a minimum amount of time needed for recovery.

 

The surgeons at Saint Luke’s Hospital have extensive experience in ACL reconstruction surgery, using state of the art equipment and the latest technology to provide the best results at the most affordable prices.

Procedure

ACL reconstruction surgery usually takes two to two and half hours and is performed using general anesthesia or spinal anesthesia. Because the procedure can be done arthroscopically, it often is performed as an outpatient procedure, although the surgeon may prefer an overnight stay at the hospital.

 

An incision is made over the front of the knee to expose the patella (knee cap) and the patellar ligament, which keeps the patella in place. A strip from the patellar ligament and the tibia is removed. This strip is called an autograft, and will be used as a replacement for the damaged ACL. The incision is then closed. The rest of the procedure will be performed arthroscopically, through small incisions on the sides of the knee. The surgeon uses a small video camera to see inside the knee and make sure that the new ACL is positioned correctly. With the knee bent, the damaged ACL is removed. A pin is then inserted diagonally, to the tibia to the femur. The surgeon will use the pin as a guide to create the new ACL. And with the pin as a guide, the surgeon drills holes in the tibia and femur. The autograft is attached to the guide pin. It is then pulled through the holes and into place. Special screws secure the bony ends of the autograft to the femur and tibia. The knee is flexed to test the new joint. After the knee is bandaged, you are taken to the recovery room for 2 to 3 hours.

 

Risks

As with any procedure there are risks associated with ACL surgery. The following is a summary of the most common risks and complications.

 

   •  Graft impingement. If the drill holes in the bone are incorrectly positioned, this may restrict the normal

       movement of the knee. This may be treated with physical therapy, or a new graft may be required.

   •  Infections requiring antibiotics and in some cases hospitalization

   •  Excess bleeding which can cause swelling of the joint and pain

   •  Normal risks of general anesthesia

 

Risks can be minimized by following the surgeon's instructions before and after surgery.

 

This information should be used only as a guide to your medical procedure. All specifics will be discussed with your surgeon at your consultation. For more information about our packages for ACL surgery at Saint Luke's, contact us by using the attached “Ask a Question” form.