It is not possible to repair a torn ACL by stitching it back together. However, it can be reconstructed by using grafts to replicate the function of the damaged ligament.
The (ACL) is the commonest ligament in the knee that needs to be reconstructed. There are two ways to reconstruct this ligament; one is to use the hamstring tendons (semitendinosus and gracilis tendons); the other is to use the central third of the patellar (kneecap) tendon. For the majority of cases, Mr. Gohil uses hamstring grafts since the cuts required to perform this surgery are significantly smaller than using the central third of the patella tendon. A small cut of 3-4cms cut is made over the upper leg to remove the hamstring grafts. (Fig. 1)
The majority of ACL reconstruction surgery is performed using arthroscopy so that the knee joint does not have to be opened. This speeds recovery and significantly reduces the amount of post-operative pain.
The procedure involves removing the ruptured ligament and placing the hamstring graft in the correct position to allow it to reproduce anterior cruciate ligament function. (Fig. 2)
Following anterior cruciate ligament reconstruction, some patients do go home on the same day of surgery. If your surgery is in the afternoon, you usually stay in overnight in the hospital. Physiotherapy is needed for the first 6 months after the procedure, initially to allow a full range of movement of the joint to be regained, then to start building muscle power and finally to retrain the knee in sensing its joint position (proprioception). Sporting activities should be avoided for 9-12 months after this procedure
Photo of a Right knee. The incisions I use for ACL reconstruction are shown in red.
The smaller incisions are arthroscopic portals and the larger incision is used to harvest your hamstring tendons.
Fig's 2 & 3: Postoperative X-rays after ACL reconstruction
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