In 2014, Dr. Micucci, an orthopedic surgeon at Mountainstate Orthopedic Associates (MOA), wrote a white paper discussing research conducted by him and three other physicians on anterior cruciate ligament (ACL) reconstruction. In this paper, he also documented their methods of construction and the outcomes.
Over the years, our orthopedic surgeons have received some frequently asked questions about ACL reconstruction, including:
What is the difference between ACL, posterior cruciate ligament (PCL) and (medial collateral ligament (MCL) injuries?
What is ACL reconstruction surgery?
Who is a candidate for ACL reconstruction?
Learn more about these FAQs below.
ACL, PCL AND MCL INJURY DIFFERENCES
There are three bones that make up the knee joint: thighbone, shinbone and kneecap. These bones are connected by four ligaments: the medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and the posterior cruciate ligament.
The anterior cruciate ligament crosses in front of the knee cap with the posterior cruciate ligament crossing in the back. These two ligaments control mobility in the knee and provide stability to the knee as it prevents the shinbone from sliding into the thigh bone.
With that being said, an ACL injury is one of the most common sports injuries our orthopedic surgeons see. According to the American Orthopaedic Society for Sports Medicine, there are approximately 150,000 ACL injuries in the United States each year.
Symptoms of an ACL injury include:
- Hearing an audible pop or snap when the injury occurs.
- Feeling intense pain when bearing weight on the joint.
- Swelling of the knee joint.
The PCL, like the ACL, provides stability to the knee. Unlike an ACL injury, a PCL injury is less common and is typically caused by a traumatic accident like a car accident or in full contact sports.
Symptoms of a PCL injury include:
- May feel a pop or strain in the back of the knee
- Feeling mild or moderate pain, as well as instability in the knee
- Swelling around the knee
Treatment of PCL injuries are often treated conservatively.
The MCL connects the thigh bone to the shinbone. It runs along the inside of the knee and helps to control sideways movement. Injuries to the MCL usually occur in sports, including running, soccer, basketball and skiing. MCL injuries may also occur from falls or twisting injuries.
Symptoms of an MCL injury include:
- May feel a pop or strain inside the knee
- Swelling around the knee
- Feeling instability in the knee
Treatment for this injury is typically non-surgical. Your physician may recommend applying ice to the injury and resting the knee. If the injury is more severe, your physician may recommend wearing a brace.
WHO IS A CANDIDATE FOR ACL RECONSTRUCTION?
Of the 150,000 ACL injuries that occur each year, only 100,000 ACL reconstruction surgeries are performed. Meaning, not everyone who has an ACL injury needs surgery. Good candidates for ACL reconstruction surgery include:
- Athletes who would like to continue in their sport
- Younger individuals
- Individuals who have more than one injury to their knee
- Individuals who are presenting a locked knee as that could be a sign of a previous knee injury
- Individual who have the feeling of the knee “giving way”
WHAT IS ACL RECONSTRUCTION SURGERY?
BEFORE THE PROCEDURE
Before the procedure, your orthopedic surgeon will sit down with you to discuss your injury, as well as any medications you may be taking. In the weeks prior to your surgery, your orthopedic surgeon may recommend physical therapy to reduce pain and swelling and improve range of motion before the surgery. Your doctor may also ask that you stop taking any medication like blood thinners prior to your surgery.
DURING THE PROCEDURE
During the procedure, general and/or regional anesthesia is utilized, and your surgeon will make small incisions along the knee. One incision will hold an arthroscope, and the other incision will be used to access the injury.
Your surgeon will remove the damaged part of the ACL and replace it with a strong tendon. To place the tendon, the surgeon will drill sockets and tunnels into the thigh bone and shinbone and secure them with screws or other fixation devices. This tendon will serve as a roadmap for the new ligament to grow.
AFTER THE PROCEDURE
ACL reconstruction is an outpatient procedure, meaning you can expect to go home within the same day.
Before you are discharged, you will be instructed on how to control any swelling and pain. Your surgeon may recommend that you keep your leg elevated, apply ice and rest as much as you can.
Recovery time can take anywhere between eight to 12 months; however, within the first few weeks, you should be able to regain a functional range of motion of the knee.
During this time, your surgeon may recommend physical therapy sessions.
Risks associated with this surgery include knee pain, stiffness, swelling, recurrent instability and re-tears. It is important that you follow all of your surgeon’s instructions as it is their goal to help you regain mobility in your knee, and return to your prior level of function.
ACL RECONSTRUCTION SURGERY | MOUNTAINSTATE ORTHOPEDIC ASSOCIATES
Mountainstate Orthopedic Associates is one of the region’s leading orthopedic practices. We take pride in the education and experience that each of our doctors holds.
From your initial appointment to the conclusion of your treatment, we strive to keep you informed and active in the decision-making process.
We also seek to be minimally invasive in our treatments, reducing the amount of time a patient is in the hospital. With many of our surgical treatments, patients are home the same day of surgery.
If you are suffering from a sports-related injury, get in touch — we’ll schedule an appointment and discuss our recommended course of action.