ACL reconstruction is recommended for individuals with an ACL tear who want to maintain an active lifestyle involving participation in competitive sports or cutting/pivoting activities. ACL reconstruction involves rebuilding the ACL using a graft placed through tunnels created in the femur and tibia.
Graft options for ACL reconstruction include a portion of the patella tendon (bone-patella tendon-bone autograft), two of the hamstring tendons (hamstring autograft), a portion of the quadriceps tendon (quad tendon autograft), and a variety of cadaveric tissue options (allograft). Each graft source has its respective pro’s and con’s, and there is no one option that is right for everyone. Dr. Driscoll will discuss the options with you and help you select the graft that is right for you.
If a significant meniscus tear is encountered, it will be treated with either arthroscopic meniscus repair or partial meniscectomy. The decision between repair and partial meniscectomy depends on the location and type of meniscus tear. While most meniscus tears are not repairable because of limited healing potential, tears treated concurrently with ACL reconstruction tend to do better. If there is a good chance that the meniscus will heal following a repair, then the repair should be performed.
Arthroscopic ACL reconstruction is an outpatient surgery. Patients go home the same day with a knee brace. A knee brace is generally worn for only the first week to encourage full extension. Most patients are allowed to return to their activities by 6 months after surgery, but full recovery may take up to 1 year.
ACL Reconstruction Techniques Continue to Evolve, but Hurdles Lie Ahead
By: Matthew Driscoll, MD
Anterior cruciate ligament (ACL) reconstruction remains one of the most common procedures in orthopaedic surgery, with an estimated 100,000 performed annually in the United States alone. Over the past 40 to 50 years, treatment of ACL injuries has evolved, from nonanatomic extra-articular procedures with large incisions to entirely arthroscopic anatomic reconstructions; from postoperative casting and delayed weight bearing to immediate range of motion and early rehabilitation; and from minimal published literature to an abundance, with more than 1,200 articles published on the topic annually in recent years.