ACL Reconstruction

Replaces torn Anterior Cruciate Ligaments (ACL)

ACL reconstruction replaces your torn ACL and restores stability to your knee. After you and your physician decide that ACL reconstruction is the best option for you, you and your caregiver will work with your therapist to prepare for your surgery.

Your therapist will design a pre-operative and post-operative rehabilitation program specifically for you. You will understand what to expect and what you need to do during the various stages of recovery.

ACL tears
How do you tear an ACL?
When should you suspect an ACL tear?
ACL surgery
Graft choice
Arthroscopy
Remove ACL and clean notch
Tunnels for the graft
The new ACL
Inserting the new ACL

ACL tears

ACL tears typically occur:

In non-contact sports or situations
With an unexpected change of direction while the foot is planted
When landing awkwardly
An ACL tear is a major injury. Patients describe falling to the ground and knowing immediately that they had done something bad to their knee.

High risk sports:

Basketball
Football
Soccer
Volleyball
Gymnastics
Skiing

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How do you tear an ACL?

Non contact tears occur when the foot is planted with a flexed knee and the person makes a sudden change in direction.

Cutting, twisting, pivoting and jumping (landing unpredictably) are common ways of tearing the ACL without involving another person.

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When should you suspect an ACL tear?

Those who have been diagnosed with an ACL tear often describe hearing a loud pop. They also feel that the injury was major and generally cannot continue their activity or sport.

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ACL surgery

Anterior Cruciate Ligament (ACL) reconstruction surgery creates a new ligament inside your knee to replace the torn ACL and restore stability to the knee joint.

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Graft choice

The Shelbourne Knee Center at Methodist Hospital uses a section of patellar tendon to reconstruct the torn or missing ACL.

This can be taken from either knee. After years of experience we have found that taking the graft from the opposite knee allows for a faster, more predictable recovery.

We choose the patellar tendon over other grafts because it is a strong graft with a low failure rate.

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Arthroscopy

ACL reconstruction begins with an arthroscopy (scope). This procedure is used to examine the knee joint and look for meniscal and/or bone surface damage. These injuries are treated at this time.

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Remove ACL and Clean Notch

Following the scope, ACL reconstruction begins with a 3 inch incision in the front of the knee. After exposing the knee joint, the damaged ACL is removed and the surrounding area (notch) is cleaned to make room for the new ACL.

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Tunnels for the graft

Tunnels* are drilled independently through the tibia and femur so the graft can be placed.

*Tunnel placements illustrated are approx locations

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The new ACL

The new ACL is a graft obtained from the patellar tendon. The graft can be taken from the other normal knee. This is called a contralateral graft. The graft can also be taken from the knee with the torn ACL. This graft is known as an ipsilateral graft. The graft is removed with bone (bone plugs) from the knee cap (patella) and the shin (tibia) at both ends.

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Inserting the new ACL

Each of the bony ends are inserted into the tunnels and the graft is pulled into place. Sutures are attached to the bone plugs and then tied over buttons to hold the graft in place. A light dressing is applied and the patient is taken to a private room for an overnight stay.

Before being dismissed from the hospital, the postoperative rehabilitation program is outlined and demonstrated for both the patient and family.