What is the ACL?
“ACL Reconstruction Surgery With @drnimamehran”
📝 Anterior cruciate ligament connects the thigh bone (femur) to the shin bone (tibia) and crosses in front of the posterior cruciate ligament (PCL). It prevents the majority of anterior tibial translation (the tibia shifting forward relative to the femur). It also provides rotational stability, as well as, some side to side stability.
Most commonly the ACL is injured during sporting events as a non-contact injury. However, it can also occur in landings from jumps and contact injuries. Working on proper jumping and cutting mechanics is the most important aspect of rehab from an ACL injury and for preventing that injury in the first place!
Everyone who tears their ACL does not necessarily need to have surgery. If you do not participate in activities that require cutting or pivoting, you may be able to have success without surgery and concentrate on physical therapy and rehab. There is also a growing body of evidence to suggest that some that do participate in higher level activities may be able to cope and perform without an ACL - more research is needed to identify who these individuals may be however. This is an important discussion to have with your local orthopedic surgeon.
If you are indicated for an ACL reconstruction, picking a graft is an important part of your preoperative discussion. There is no perfect graft choice. They each have risks and benefits. The most important decision is determining if you should use your own tissue (autograft) or someone else’s tissue (allograft). If you are young and/or playing high-velocity sports autograft is generally the better option. However, if you have a lower activity level and are over 40 studies have shown that there is equal success with an allograft.
If you and your surgeon choose autograft, there are several autograft options including patellar tendon, hamstring tendon, and quadriceps tendon. Each graft has its advantages and disadvantages, please see the video above for a full discussion of graft options.