The anterior cruciate ligament, or ACL, is one of four major ligaments in the knee that provide stability to the joint. When a patient sustains a tear to the ACL, a sensation of instability, or giving out, may develop in the injured knee. In order to restore stability to the knee, your doctor may recommend an ACL reconstruction to insert a new ligament in the place of the damaged ACL.

Early surgical intervention to repair a torn ACL is not recommended in the vast majority of cases, and physiotherapy for at least four to six weeks is almost always recommended first in the amateur sportsperson. This approach has the advantage of allowing any other associated injuries to settle, and any inflammation to subside. Taking time to have physiotherapy also gives the patient and physiotherapist the opportunity to assess whether they feel there is a genuine need for reconstruction.

Compared with surgery for meniscal tears, ACL reconstruction is a much more involved procedure as it involves taking a tendon graft as indicated (usually the hamstring) from another part of the leg and using this to substitute the broken ligament. The time taken to recover from this type of surgery is much longer than for meniscal tears, and it may take up to nine months before you are able to undertake full sporting activities again.

Most ACL reconstruction surgeries are done using a single-bundle reconstruction. A single-bundle ACL reconstruction uses a tendon graft to replace the torn ACL. Unfortunately, ACL tears cannot be repaired, or sewn together, and a graft must be used to reconstruct the ligament. When the ACL is reconstructed, the graft is placed in the position of the anteromedial bundle. Grafts are held in place by making a hole in the bone called a tunnel. One tunnel is made in the femur and one in the tibia.

Instead of placing just one larger graft, the double-bundle ACL reconstruction procedure uses two smaller grafts. Therefore, there are essentially two ligament reconstructions, one for each bundle. The double-bundle procedure requires two additional bone tunnels to accommodate a second graft, and one additional incision. Studies have demonstrated some advantages of the double-bundle ACL reconstruction.

This is a new procedure, and as is the case with any new procedure, the long-term results are not well understood. It is possible that this procedure will be an improvement on the standard single-bundle ACL reconstructions, but it is also possible that these patients may have the same, or even worse, long-term results. No one really knows just yet. The double-bundle is technically more demanding of a procedure, and there are fewer surgeons with experience in this surgical technique.

It is not clear that the double-bundle ACL reconstruction is a better procedure, but some patients are willing to try a new procedure in an effort to possibly improve their long-term result. Standard single-bundle ACL reconstructions have excellent results, with about 90% of patients able to return to activities at their pre-injury level. However, the results are not 100%, and some patients have persistent instability after ACL reconstructions, and may develop problems later in life.

A graft is the tissue we will use to give you a new ACL. The choices available break down into two large categories. Autograft, your own tissue; or allograft, cadaveric tissue. If you elect to utilize your own tissue, the three grafts available are bone-patella tendon-bone grafts, quadriceps tendon grafts, and hamstring grafts. There are many different allografts available to reconstruct the ACL.

One of the main priorities after ACL reconstruction is to regain the knee range of motion. This along with establishing a good strengthening program is usually best done two to three times per week for the first four to six weeks. Because many insurance policies will not cover this many visits to the therapist, an independent home program may need to be instructed earlier. Compliance in performing the exercises in and out of the clinic is the key.

No. Many ACL tears can be treated non-operatively. Many factors go into the decision making process. Some patients have ACL tears and no instability symptoms. Others are profoundly symptomatic, even with simple stair climbing, turning and twisting. We do not know why some people are more symptomatic than others, which is why surgery is not the right answer for everybody.

a general rule, the body cannot repair a torn ACL if the tear is complete. Partial tears may sometimes heal but often will progress to becoming complete tears. If surgery is needed, the surgeon will not repair the ligament directly, as this has a low success rate, but will instead use a nearby tendon to reconstruct the original ligament. Your future demands in multi-directional sport.

The damaged ACL cannot be sewn back together as it will not heal. A torn ACL will require a reconstructive procedure using transplantable tendons from your body (autografts) such as the hamstring, bone-patella-tendon-bone (BTB) or quadriceps tendons, to reconstruct this torn ligament. Allograft (tissue bank cadaver tissue) tissue is often used with less pain to you and earlier return to function. Both autograft and allograft tendons are acceptable to use for ACL reconstructions.

Not always. Some people are able to function normally without surgery, so long as they have physiotherapy, but others need reconstructive surgery no matter how much physiotherapy they have. Whether or not you have your ACL reconstructed also depends on how active you are, and how your injury impacts on your daily and sporting activities.

Unless the surgeon advises otherwise, most people return to enjoying both of these sports with the use of a brace. However, remember every individual injury is different. Following the recommendations of the surgeon is of utmost importance.

Absolutely. The hips are rarely the cause of acute limping. If the ACLs are torn, your pet is only going to get worse.

The ACL (Anterior Cruciate Ligament) is a ligament in the center of your knee. The ACL gets damaged when twisted too far, which makes it a common injury in relation to sports or other physical activity. ACL Reconstruction is performed using a combination of open surgery and arthroscopic surgery. Before ACL reconstruction process begins, your surgeon will examine your knee arthroscopically, and repair any additional damage to the knee, such as a torn meniscus, or worn articular cartilage.

The ACL is the Anterior Cruciate Ligament. There are more than 4 major ligaments that essentially hold the knee together. Without one of more of these ligaments the knee would be loose and you would perceive that the knee was giving way or buckling. The ACL is the most commonly torn knee ligament. The ACL is usually torn as the result of a non-contact twisting injury. You will usually feel or hear a pop, the knee will buckle and within a short period of time, significant swelling will occur.

Recovery from an ACL injury varies with each individual. Your treatment should continue until your knee is stable and strong, not for a certain length of time. ACL injuries in children and teens are less common than in adults, but they do occur, especially in teens. An untreated or unsuccessfully treated ACL injury in children or teens may result in future knee problems. The knee may become more and more unstable and, over time, osteoarthritis may develop.