The Science of ACL Reconstruction

ACL injuries are all too common in athletes these days. But the fact is, of the over 150,000 annual cases, 30% of them aren’t sports related. Injury to the ACL is primarily caused by a sudden deceleration or change in direction while running, but it can also happen in the middle performing of daily tasks, such as climbing stairs or getting out of bed.

The ACL is the anterior cruciate ligament and is one of two interior ligaments in the knee that prevent the base of the femur and the top of the tibia from shifting away from each other. Unlike many body parts, the ACL cannot repair itself. If it ruptures, it will need to be repaired surgically.

ACL reconstruction surgery can be performed in two ways: open or arthroscopic. The open approach to ACL reconstruction surgery involves making a large incision in the leg and peeling back the skin and muscle. This approach is not as common in today’s medical practices. Today, most ACL procedures are performed arthroscopically, which involves making multiple small incisions using probes to maneuver tools in the knee.

The first thing that occurs in the reconstructive process is the removal of the old ligament. Once this is done, the surgeon drills diagonal “anchor” holes through the bottom of the femur and top of the tibia. Next, a new ligament is pulled through the holes in the bones to recreate the original ligament. The new ligament is typically harvested from the hamstring but can also be taken from other parts of the body or a cadaver. The new ligament is then secured in place in the bones and the recovery process can begin. Though the ACL can’t re-attach itself, the body will begin to regrow tissue on the new ligament. After several months, or around a year, the new ligament is strong enough to hold up and many people don’t have problems with it again.

This is a simplified explanation of the surgery, and exact procedures for this surgery vary from patient to patient. Our Dr. Richard Jackson has performed ACL reconstruction surgery numerous times and has an outstanding record of success. For more information on ACL procedures, please contact us at 317.455.1064.