Anterior Cruciate Ligament ACL
Injuries of the anterior cruciate ligament of the knee are among the most limiting conditions for athletes. The instability caused by the injury does not allow for sport activity. This is why anterior cruciate ligament reconstructive surgery is required in most cases.
The type of reconstruction has changed over the last century. The first attempts to repair the ligament itself did not give favorable results and is not currently considered a viable option. Reconstruction with different types of grafts and the position where the new ligament is placed, are the variables in the procedure.
The use of a graft harvested from the patient is the most common procedure. Basically the central portion of the patellar tendon known as BTB (bone tendon bone) and hamstrings (semitendinosus tendon and gracilis muscle or gracilis) are the most used worldwide. Use of the quadriceps tendon is increasing but is less widespread.
The main problems with these grafts are at the donor site, and residual pain. The success of this surgery is based on the ability to get the patient back to their daily life activities in the same condition prior to the injury. In sports that require rotation of the knee patellar grafts are used more frequently for offering better bone fixation and less laxity of the fibers. Graft placement is of utmost importance. Today most experienced teams in anterior cruciate ligament reconstruction use anatomical reconstruction techniques in an attempt to imitate the position and function of the natural ligament.
The use of donor grafts is also common for a large number of patients who have suffered previous injuries of the anterior cruciate and the use of autografts is not possible or simply prefer not to use autograft. The results are also excellent, with the benefit of avoiding the problems that can occur at the donor site.
The reconstruction technique combines many details that must be taken into account and it is highly recommended to be performed by highly experienced teams. Results are measured by the patient's ability to return to sport with specific tests.