ACL Tear
ACL - Anterior Cruciate Ligament
ACL is a centrally located ligament that is crucial for preventing abnormal rotatory instability and to prevent forward movement of the leg bone.
Causes : Sports / Jumping & landing injuries / Two wheeler accidents.
ACL has a poor blood supply and does not heal on its own and it requires a reconstruction with a tendon graft. Tendons like hamstrings, quadriceps, bone patella tendon or peroneus longus from around the knee are used for reconstruction.
ACL Reconstruction
The well established and common technique uses one or two of the hamstring tendons (semitendinosus/gracilize) to reconstruct the ACL. The graft is fixed with a titanium button and loop in the femur and with a bio absorbable screw in the tibia.
ACL - Special Situations
ACL reconstruction has to be suited to individual needs and grade of injuriy and the presence of additional injuries.Athletes, dancers, younger patients and revision requires individualised assessment & procedure selection. Special grafts like BPTB, Peroneus longus and Quadriceps tendon and additional procedures to support ACL graft are used in special situations.
HIGH GRADE INJURIES & SPORTSPERSONS
In high velocity injuries, in addition to ACL, supporting structures like anterolateral ligament (ALL) are also torn resulting in a high grade instability. Failure to address the
additional injury leads to suboptimal results and failures.
Contact Athletes & Revision Surgery
Bone Patella tendon bone graft uses the central third of the patellar tendon along with
bone plugs. Often referred as the Gold Standard, this is the prefererred graft for contact
and high level athletes and in the revision setting. as the healing rates are quicker.
Paediatric ACL Injury
ACL injuries in children are challenging due to the presence of growth plate. Techniques to avoid injury to the growing ends – Primary repair, All epiphyseal and physicals sparing techniques are employed to treat ACL injuries in children.