One of the most commonly injured structures in the knee, and one of the most notorious for athletes of all ages, is the anterior cruciate ligament (ACL). Frequently these injuries are managed surgically and there are over 100,000 ACL procedures performed annually in the United States. It has grown to become one of the more predictably successful operations that orthopedic surgeons can offer patients. It is quite remarkable that with current surgical techniques, a patient can undergo an ACL reconstruction and essentially be back to full function from an athletic standpoint within 8 months.
The anterior cruciate ligament (ACL) is one of four major ligaments that stabilize the knee joint. The primary function of the ACL is to prevent rotation and forward translation of the tibia (shine bone) with relation to the femur (thigh bone). Typically, ACL injuries occur while playing sports when the knee is stopped abruptly or is planted/twisted with enough force to tear the ACL. The classic report of “twisting the knee and feeling a pop” is what the majority of people will report when they have an ACL tear. This is usually followed by substantial pain and swelling that dissipates over the next few days. For the vast majority of young patients that sustain an ACL injury, surgical correction is the best option.
Modern day ACL reconstructive surgery is performed via an arthroscopically assisted technique which means that it is minimally invasive and done through very small incisions under the guidance of a high definition video camera. The surgery is performed to reconstruct (replace) the torn native ACL by taking a graft, either from a tendon around the knee or from a cadaver, and securing it in place where the torn ACL had been. The surgery is typically done on an outpatient basis meaning that the patient goes home after the surgery and a stay in the hospital is not necessary. After the surgery, patients are able to walk with crutches immediately and perform the majority of everyday tasks typically right away. However, return to full function takes several months and patients are guided through a rehabilitation process during this time. The typical time frame to return to athletics is around 8 months and patients can expect a full recovery.
As a fellowship trained sports medicine and arthroscopic surgeon, I feel as though I am on the cutting edge of ACL reconstruction as over the years the improvements in techniques have led to faster recoveries and better outcomes. I am happy to be able to offer my patients all of the benefits of the most novel techniques of ACL surgery.