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Arthroscopic ACL Reconstruction Video


Arthroscopic ACL Reconstruction Slideshow


Anterior cruciate ligament (ACL) ligament injury is very common.  The ACL is the main stabilizer of the knee as we perform cutting or side-to-side activities and actions that require stopping and starting.  Most injuries occur after plant the foot or land on the leg after jumping and twisting the knee.  Other times a direct blow to the knee can tear the ligament.  ACL injuries can occur in isolation or other structures can also be involved including other ligaments, the menisci, the bone, and the articular cartilage.  ACL ligament tears do not heal by themselves.  Once torn, the ligament will remain loose but the patient may or may not have problems with the knee after the initial swelling and pain have resolved. The main symptom after an ACL tear is looseness or giving way of the knee.  Patients that are younger and more active are more likely to have trouble with there knees after an ACL tear and are at a high risk of injuring other structures in their knees because of the potential for the knee to give way after an ACL tear.  Non-surgical treatment includes controlling the swelling and pain followed by exercises to return motion and strength the knee.  Surgical treatment involves removing the torn ACL remnants and grafting a new ligament in its place.  The new ligament is made either form tissue harvested from the patient (autograft) or from process tissue from an organ donor (allograft).  There are several different types of autografts and allografts used that have their specific benefits and risks. We are proficient with the use of all graft types and individualize graft selection for each patient after a thorough discussion.  Complete recovery from the surgery usually takes 4-6 months and requires some bracing and rehabilitation.  Rehabilitation is arguably the most important part of the process.  In order for the knee to return to good function, the patient must get the knee to move and regain strength of the leg muscles.  Most patients work with a therapist although the exact process of rehabilitation is also individualized.

Revision ACL reconstruction is challenging but can provide significant relief for patients with knee instability after a previous reconstruction.  Revision surgery can involve removal of hardware, bone grafting the previously created tunnels for ligament reconstruction, and finally reconstruction of the ACL.  Many times, the revision can be performed with one procedure. Occasionally, a revision must be performed in two stages in order achieve a good result.