Anterior Cruciate Ligament (ACL) Reconstruction

It is not possible to repair a torn ACL by stitching it back together. However, it can be reconstructed by using grafts to replicate the function of the damaged ligament.

The (ACL) is the commonest ligament in the knee that needs to be reconstructed.

There are two ways to reconstruct this ligament; one is to use the hamstring tendons (semitendinosus and gracilis tendons) (tendons are similar to ligaments, except that tendons attach muscles to bones); the other is to use the central third of the patellar (kneecap) tendon.

For the majority of cases, Mr Gohil uses hamstring grafts since the cuts required to perform this surgery are significantly smaller than using the central third of the patella tendon. A small cut of 3–4 cm is made over the upper leg to remove the hamstring grafts.
Fig 1: Photo of a Right knee. The incisions used for ACL reconstruction are shown in red. The smaller incisions are arthroscopic portals and the larger incision is used to harvest your hamstring tendons.
Fig 2: Brace worn for the first two weeks following your ACL surgery.
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The majority of ACL reconstruction surgery is performed using arthroscopy so that the knee joint does not have to be opened. This speeds recovery and significantly reduces the amount of post-operative pain.

The procedure involves removing the ruptured ligament and placing the hamstring graft in the correct position to allow it to reproduce anterior cruciate ligament function.
Fig 3: Postoperative X-rays after ACL reconstruction.
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Following anterior cruciate ligament reconstruction, a hospital stay of 24–48 hours is required. Physiotherapy is needed for the first six months after the procedure, initially to allow a full range of movement of the joint to be regained, then to start building muscle power and finally to retrain the knee in sensing its joint position (proprioception).

Sporting activities should be avoided for six months after this procedure.

You may also like to view the most frequently asked questions about knees.
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