You are here

The weekend doctor

“All-inside ACL reconstruction” procedure for torn ACL

By Jim Davidson, MD
Blanchard Valley Orthopedics and Sports Medicine

The anterior cruciate ligament (ACL) is the ligament in the center of the knee that prevents the shin bone from separating from the thigh bone and prevents the knee from being stretched beyond its normal limits.

Healthy maintenance of this ligament is important, as an injury can be especially painful and disruptive. Neglecting a tear of this ligament can also lead to further damage such as cartilage tears and arthritis. Fortunately, here has been a new development in the technique of ACL reconstruction. The new procedure is called “All-inside ACL reconstruction.”

In early ACL reconstruction techniques, large incisions were required to repair tears. Later, the procedure improved by using smaller incisions and inserting a camera into the patient’s knee to project the surgery onto a monitor.

Now, the All-inside ACL reconstruction procedure is less invasive and more efficient than previous techniques by using small “poke-hole” incisions inside the knee rather than large incisions.

Additionally, the procedure uses graft harvested from either the patient or a donor. This graft is assembled for implantation by double-fixing it at each end with a titanium washer and sutures, then threaded through the tunnels inside the knee under camera visualization and pulled tight. The tunnel pathways are placed to mimic the native ACL’s attachments, which makes the placement of the graft more accurate.

This minimally invasive technique helps patients recover more quickly. There is less pain, smaller incisions and shorter rehabilitation periods. After a course of rehabilitation, most patients regain normal range of motion and control. Stability of the knee is regained with the new ACL graft, and healing and incorporation of the graft is achieved fully in 4.5 months. Lighter activity can begin even sooner.

The benefits of All-inside ACL reconstruction are especially valuable for athletes or patients with an active lifestyle. Previously, an ACL tear or break could ruin an athlete’s career. However, thanks to the improvements provided from this procedure, physically active patients can return to their lifestyle with minimal recovery time and less pain.

If you have an ACL tear, ask your orthopedic surgeon if this procedure is right for you.