The anterior cruciate ligament (ACL) is one of the major stabilizing ligaments in the knee. It is a strong rope-like structure located in the center of the knee, running from the femur to the tibia. The ACL is one of the four major ligaments of the knee that connects the femur (thighbone) to the tibia (shinbone) and helps stabilize your knee joint. It prevents excessive forward movement of the lower leg bone (tibia) in relation to the thighbone (femur) as well as limits rotational movements of the knee.
When this ligament tears, unfortunately, it does not heal, and often leads to the feeling of instability in the knee. A tear in this ligament can make you feel as though your knees will not allow you to move or even hold you up.
An ACL injury most commonly occurs during sports that involve twisting or overextending your knee. An ACL can be injured in several ways:
When you injure your ACL, you may hear a loud “pop” sound and feel the knee buckle. Within a few hours after an ACL injury, your knee may swell due to bleeding from vessels within the torn ligament. You may notice that the knee feels unstable or seems to give way, especially when trying to change direction on the knee.
An ACL injury can be diagnosed with a thorough physical examination of the knee and diagnostic tests such as X-rays, MRI scans and arthroscopy. X-rays may be needed to rule out any fractures. In addition, your doctor will often perform the Lachman’s test to see if the ACL is intact. During a Lachman test, knees with a torn ACL may show an increased forward movement of the tibia and a soft or mushy endpoint compared to a healthy knee.
A pivot shift test is another test to assess an ACL tear. During this test, if the ACL is torn, the tibia will move forward when the knee is completely straight and as the knee bends past 30°, the tibia shifts back into correct place in relation to the femur.
Anterior cruciate ligament reconstruction is a surgery to reconstruct the torn ligament of your knee with a tissue graft. The goal of ACL reconstruction surgery is to tighten your knee ligament and restore its stability. It is a commonly performed surgical procedure, and with recent advances in arthroscopic surgery, can be performed with minimal incisions and low complication rates.
Anterior cruciate ligament reconstruction hamstring method is a surgical procedure to replace the torn ACL with part of the hamstring tendon taken from your own leg. The hamstring is the muscle located on the back of your thigh. The procedure is performed under general anesthesia. Your surgeon will make two small cuts, about 1/4-inch-long, around your knee. An arthroscope, a tube with a small video camera on the end, is inserted through one incision to view the inside of the knee joint. Along with the arthroscope, a sterile solution is pumped into the joint to expand it, enabling your surgeon to have a clear view and space to work inside the joint.
The knee is bent at right angles and the hamstring tendons felt. A small incision is made over the hamstring tendon attachment to the tibia and the two tendons are stripped off the muscle and the graft is prepared. The torn ACL will be removed and the pathway for the new ACL is prepared. The arthroscope is reinserted into the knee joint through one of the small incisions. Small holes are drilled into the upper and lower leg bones where these bones come together at the knee joint. The holes form tunnels in your bone to accept the new graft. The graft is pulled through the predrilled holes in the tibia and femur. The new tendon is then fixed into the bone with screws to hold it in place while the ligament heals into the bone. The incisions are then closed with sutures and a dressing is placed.
The anterior cruciate ligament reconstruction patellar tendon is a surgical procedure to replace the torn ACL with part of the patellar tendon taken from your own leg. The new ACL is harvested from the patellar tendon that connects the bottom of the kneecap (patella) to the top of the shinbone (tibia). The procedure is performed under general anesthesia. Your surgeon will make two small cuts about ¼ inch around your knee. An arthroscope, a tube with a small video camera on the end is inserted through one incision to view the inside of the knee joint. Along with the arthroscope, a sterile solution is pumped into the knee to expand it, providing your surgeon to have a clear view of the inside of the joint.
The torn ACL will be removed and the pathway for the new ACL is prepared. Your surgeon makes an incision over the patellar tendon and takes out the middle third of the patellar tendon, along with small plugs of bone where it is attached to each end. The remaining portions of the patellar tendon on either side of the graft are sutured back after its removal. Then, the incision is closed. The arthroscope is reinserted into the knee joint through one of the small incisions. Small holes are drilled into the upper and lower leg bones where these bones come together at the knee joint. The holes form tunnels in your bone to accept the new graft. The graft is pulled through the predrilled holes in the tibia and femur. The new tendon is then fixed into the bone with screws to hold it in place while the ligament heals into the bone. The incisions are then closed with sutures and a dressing is placed.
The possible risks and complications associated with ACL reconstruction with the hamstring and patellar tendon methods include:
Following the surgery, rehabilitation begins immediately. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement.