ACL (Anterior Cruciate Ligament) Repair

ACL tears are increasing in frequency secondary to increased levels of participation, frequency of games and practice.

ACL tears are a common injury and being seen with greater frequency and at younger ages. Tears lead to loss of time from sport and activities and can lead to further joint deterioration without prompt recognition and treatment. The standard treatment is a reconstruction with autograft (patients tissue) or allograft (donor, cadaveric tissue). The choice of graft depends on several factors including age of patient and sports activity level. Currently, the time to return to sport has been shown to effect re-injury rates. Historically, 6 months after surgical reconstruction was considered an appropriate time to return to sports without restrictions. This notion has been challenged by recent studies noting lower re-injury rates by waiting 9 months or more to return to sports.

ACL graft (hamstrings)

Newer surgical instruments and a retrospective look at studies from decades ago regarding primary repair have lead to resurgence in interest in primary repair instead of reconstruction. Failure rates have been high with this technique in previous studies that lead to the abandonment of this procedure. However, when evaluating the results or success of repair in specific tears, the results can approach that of a reconstruction. Specifically, proximal tears (from the femur) have better success when repaired. The advantage of a repair is that the ACL can be saved, less invasiveness and potentially faster return to sports. If the repair were to fail the standard options for reconstruction still exist. This is particularly attractive in pediatric patients where reconstruction techniques can injure growth plates.

Not every patient is a candidate but the option should be available for those patients inclined to have a repair over a reconstruction. I offer this to my patients who are appropriate candidates based on MRI appearance and surgical evaluation. Below is a short video demonstrating a repair I performed and the technique utilized.

Video of ACL Repair

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: