ACL Reconstruction Hamstring Tendon

The Hamstring-Tendon method of Anterior Cruciate Ligament reconstruction surgery is an advanced procedure that completely (or partially) replaces a damaged ACL with a grafted piece of hamstring tendon. Being one of the primary ligaments of the knee joint, the anterior cruciate ligament connects the femur to the tibia and is largely responsible for the stabilization of the knee. A damaged ACL has the potential to severely limit the functional capacity of the knee joint and thus repairing it is essential to maintain a happy and active life.

Causes

Injuries to the anterior cruciate ligament are most commonly caused by sudden changes in direction, an abrupt deceleration or a traumatic collision. These types of injury are most commonly seen in athletes who practice high-intensity, high-impact activities. ACL injuries are serious and require immediate attention.

The most common scenarios for ACL injury are:

• A sudden change in direction during a run or sprint
• An abrupt stop
• An awkward landing from a high jump or fall
• A lateral blow to the knee, such as a tackle in football

Signs of an ACL tear

Torn ACLs typically manifest with the following set of symptoms:

• A snapping or popping sound may be heard
• Intense pain in the knee area
• Bruising/discoloration
• Swelling
• Knee joint instability when weight is applied

Diagnosis

To accurately diagnose an ACL injury, a doctor must perform a variety of tests. The first step is a physical examination. The doctor will inspect the knee, check for signs of swelling, bruising, tenderness and stiffness. The patient may be asked to flex their knee, support weight and possibly attempt to walk. If a serious injury is suspected, the physician will choose to have computerized imaging tests performed to receive a complete analysis of the exact location and severity of the injury.

Procedure

In order to restore knee function after an ACL tear, it’s best to take a proactive approach such as surgery. Tendons are compact, fibrous tissues that are extremely resilient. Yet, these thick tendons won’t heal quickly on their own. By taking a graft from the patient’s hamstring fibers, surgeons can pull from a large muscle group to replace damaged ligament tissue. Whether it’s a complete ACL Reconstruction, or partial reconstruction, the hamstring graft will be strategically cut to the proper length and promptly affixed to the existing ACL tendon or in place of the old ACL.

The operation is done under general anesthesia. Surgeons will utilize an arthroscope (a small fiber-optic camera that sends a high-resolution image to a monitor), so that they can operate within small incisions, rather than perform risky and damaging open surgery. The knee will be prepped by creating the initial incisions, moving aside tendons and muscles, and scrapping away any damaged ACL, soft tissue or bone. With the knee joint ready to accept its new, healthy replacement ACL tissue, the surgeon will make the transfer. Utilizing pins, surgical cement, a mesh or other adhesive devices, the hamstring tendon is placed within the knee and the incisions are mended.

Risks & complications

ACL reconstruction surgery always carries the possibility of complications. The most common side effects and post-operative complications include:

• Infection
• Thrombosis
• Nerve and vascular damage
• Rejection of the tendon graft
• Diminished joint function post-surgery
• Crepitus, or a grating sensation during flexion of the joint
• Persistent pain

Post-operative Care

Following a major knee surgery, patients should expect to significantly reduce their activity level, especially any strenuous movements, for the next few weeks. Once the reconstructed knee has had time to accept its new ACL tendon, patients can begin physical therapy. This enables the joint as a whole to strengthen and reclaim its stability and flexibility.

Thankfully, Anterior Cruciate Ligament Reconstruction surgery has a very high rate of success with minimal risk of complications. Additionally, in most cases of torn ACLs, surgery is the best treatment option and provides the highest chance to return the knee to its full range of motion and function.