The most effective treatment for the ACL tear is the ACL Reconstruction Surgery, where the ACL is reconstructed by replacing the damaged ligament using the tissues around your knee joint, helping to restore the knee’s function after an injury. This replacement tissue is called the Graft.
Open Surgery, and
The keyhole or Arthroscopic surgery is a more preferred option for this surgery for the following advantages:
Nearly invisible scars at the incision
Faster recovery after surgery.
Key Hole Technique used for ACL surgery.
Tiny scars after Key Hole surgery compared to long scars caused by open surgery
Tunnels placed using the latest Trans-Portal Technique.
The placing and positioning of the graft is the key factor for proper functioning of the knee and the restoration of the physiologic kinematics of the knee joint in ACL reconstruction. There are various techniques in practice for the Graft placement and positioning. The Trans-Portal technique, when compared to the Trans-Tibial technique, helps to place the graft in a more anatomical position.
The surgeon will remove the damaged ligament and then replace it with a segment of the tendon (Hamstring graft), which is a tissue similar to the ligament that connects muscle to the bone.
After the surgery, patient will have a rehabilitative therapy. A successful ACL reconstruction surgery along with this rigorous rehabilitation can help restore the knee’s stability and function and the patient can get back to their regular activities.
Graft Passed into the tunnels and fixed with Bio absorbable screw
Patients returned back to active sports after ACL reconstruction done with keyhole technique.
Materials Used for the Procedure
Types of Grafts
The different sources of tendons that are used as Grafts for reconstructing the damaged ACL are:
Bone Patellar Tendon
The Hamstring Tendon is the more preferable graft source for the reconstruction surgery, for the following reasons which reduce the risk of re-injury:
High Load to Failure strength
Stiffness of this graft
The grafting of Bone-Patellar tendon can cause the following problems:
Knee pain during the kneeling action
Hamstring Tendons used as graft for reconstructing the torn ACL.
Stable knee with complete knee movements after ACL reconstruction.
These are implants used in this procedure which will dissolve itself into the body tissues. Some of the advantages that these implants provide are:
No need to perform a surgery to remove the implant at a later stage.
These implants do not distort the CT or MRI scan images, unlike metal screws.
Devices used to fix the graft to the bone.
Authored By Dr. Raj Kanna - Orthopaedic and Knee surgeon, Chennai