McFarland Clinic

Sports Docs' Weekly Blitz: ACL Tendon Grafts

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November 9, 2016

Dear Cyclone Fanatics--as my partners, Dr Peter Buck and Dr Bryan Warme, and I have mentioned in previous posts, the Anterior Cruciate Ligament (ACL) is a very frequently injured ligament (estimates of over 250,000/year). It is the primary stabilizer of the knee, both with regard to anterior translation and rotational movement. The ACL comes into play with cutting activities, including sports such as soccer, basketball, football, and volleyball, and is typically injured in a non-contact fashion. The diagnosis is usually made by clinical history and exam, but MRI can be used as well.

torn ACL MRI   torn ACL arthroscopy

Torn ACL (seen at arthroscopy)

Without surgical treatment, the athlete typically experiences a "loose" knee, one that is unstable with pivoting sport activities. Although the knee may not give out every single time, one never knows when it will and when it won't, so the athlete is held back by the 'trick knee'.  

Treatment requires that the surgeon rebuilds (reconstructs) the ligament, using tendons. There are 3 main choices for these tendons, and each choice has its pros and cons; hamstring tendons, patellar tendon, or allograft tendon (from a cadaver donor). The choice of the graft is best discussed by the surgeon and the patient, and an educated decision can be made as appropriate for the individual.

hamstrings tendon graft

Hamstrings tendon graft

Surgical treatment restores stability to the knee by restoring the knee's normal anatomy. The keys to the surgery are basically putting the proper amount of tendon tissue in the correct position, and fixating the graft solidly so that early rehabilitation can be done (under the direction of a physical therapist). This allows the patient to get up and going quickly, limiting loss of strength and conditioning. Ultimate return to sports can take 6 months or more, requiring a lot of hard work to get back into action.

ACL reconstruction

ACL reconstruction

Hopefully none of you CFers will tear your ACL, but if you do feel free to give us a call (515-239-4475) and we can fix you up just like we do the Cyclones!  

Until next week, GO STATE! Lets get a VICTORY at KU. Dr. Thomas Greenwald

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