The anterior cruciate ligament is a small but very important structure that is in the centre of the knee joint. It connects the two large bones of the leg (the femur and tibia) and enhances the stability of the knee.
It is a very commonly injured structure during sport. It most often tears when the foot is planted and the rest of the body twists. Patients often describe a distinct pop or crack followed by immediate swelling. The most common sports that result in ACL rupture are football, netball and skiing but the ACL can be injured during any sport and even just in a fall. There are reported cases of the ligament healing itself but this is rare. The biggest reason for considering reconstruction is to protect the joint from further damage, which can occur from repeated episodes of instability.
ACL reconstruction through keyhole surgery was pioneered in the early 1990’s and was a mainstream operation by the mid 1990s. The techniques have evolved through research and today it is a day case procedure performed under general anaesthetic taking approximately 45 minutes. Tunnels are drilled from the inside to thread a new ACL called a ‘graft’ into place. There are various different types of ‘graft’ used to make the new ligament. Mr Bourke will discuss this at length with you prior to you booking your surgery. His preference in most cases is your own hamstring tendons from the inside of the thigh. These can be taken through a 3cm incision at the front of the knee and they will grow back over a period of about 3 months. Other types of graft are the central third of patellar tendon (known as BPTB) from the front of the knee or in some cases ‘allograft’ which is donor tissue.
Rehabilitation following surgery is an essential part of the recovery to prevent further injury. If you have not already seen a physiotherapist, Mr Bourke will recommend one to you in your local area that is familiar with his unique protocol.
For further information please download the following leaflets:
Patient ACL Overview
Patient ACL Rehabilitation
ACL Rehabilitation for Physiotherapists