ACL reconstruction
Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament is removed from the knee before the graft is inserted in an arthroscopic procedure.
Description
Most people have general anesthesia right before surgery. This means you will be asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this surgery.
The tissue to replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and chose to give all or part of his or her body to help others.
- Tissue taken from your own body is called an autograft. The two most common places to take tissue from are the knee cap tendon or the hamstring tendon. Your hamstring is the muscle behind your knee.
- Tissue taken from a donor is called an allograft.
The procedure is usually performed with the help of knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.
Why does the Anterior Cruciate Ligament fail to heal?
Unlike other ligaments about the joint, the ACL passes through the joint and is surrounded by joint fluid. Other ligaments heal by scar formation, however due to the unique location of the ACL the bleeding is uncontained, filling the joint, causing pain and swelling. The blood irritates the knee joint’s lining to produce synovial fluid. This fluid is designed to dissolve and prevent blood clotting within the joint. Without blood clot, scar tissue does not form. The result is that the ACL rarely heals in continuity.
