ACL Overview
Anterior cruciate ligament (ACL) injuries are one of the most common sports injuries in the United States. The ACL is one of the most important ligaments in the body, and is crucial to providing stability of the knee joint. Unfortunately, the ACL has poor healing potential, and ACL surgery is by a fellowship trained ACL surgeon is usually required to reconstruct the torn ligament in most cases. In some cases, however, the ACL can be repaired in a way that it will heal.
Most of the time, repair is not possible and a reconstruction is needed. ACL reconstruction surgery is done by taking a tendon from somewhere else in the body (or from a donor) and using it to replace the torn ACL.
Individualized, Anatomic ACL Surgery
In the past, the ACL was reconstructed in a non-anatomic fashion. In other words, the reconstructed ACL was not placed exactly where the patient’s own ACL had been located. This was done for many reasons, partially because technology and understanding of knee anatomy was limited.
However, newer imaging techniques have helped us to better understand the native ACL anatomy, and newer surgical technology and techniques have allowed us to place the reconstructed ACL in the exact place that the old one was located. This provides better knee stability and decreases the risk of future injury and arthritis.
In addition to anatomic placement, we take several measurements of the knee on the MRI and during surgery to make sure that the ACL graft is exactly the size that is needed – not too small and not too big.
ACL Reconstruction Graft Options
There are several options for grafts in ACL reconstruction, each with its own set of advantages and disadvantages. Autograft is tendon that is harvested from your own body, and allograft is tissue harvested from a donor (cadaver).
Quadriceps Tendon (QT) Autograft
The quadriceps tendon is more recently being recognized as an excellent graft choice for ACL reconstruction. The tendon is harvested just above the knee cap and provides a very thick and strong graft. In many cases, it is stronger than the hamstrings and has a greater cross sectional area (20% more) and density than the patellar tendon. In addition, there are no worries about pain in the front of the knee, difficulty kneeling, or the need to augment with donor tissue.
Bone-Patellar Tendon-Bone (BTB) Graft
This has historically been considered the gold standard, especially in competitive athletes. The two bone blocks kept on each end improve the healing of the graft within the bone tunnels, and the tendon itself is very strong.
However, it has been associated with increased incidence of pain in the front of the knee and difficulty kneeling. Also, there is a risk of patellar fracture during harvesting, and then tendon is not as thick as some other options. However, it has been used in millions of patients, many of them highly competitive athletes, with good success.
Research has shown that there may be some early quadriceps muscle weakness that resolves soon after returning to full activity. The quadriceps tendon graft can be harvested with or without a bone block. The most common way to use it is without a bone block.
Hamstrings Autograft
The hamstring tendon graft is perhaps the most popular graft in use today. One or two of the three hamstring tendons on the inside of your knee are harvested through a small incision on the front of your knee, and they are doubled or tripled over to make a graft. The hamstring tendons are very versatile and well proven in ACL reconstruction. They can be harvested through a smaller incision than the BTB graft and don’t add much time to the procedure. Patients tend to have less anterior knee pain after surgery as well.
However, some studies have suggested that they might fail at a higher rate than BTB and quadriceps tendon grafts, and that it hamstring graft may not restore rotational stability as well as BTB and quadriceps tendon; the results are not conclusive at this point. It can also be difficult to judge the size of the tendons before surgery, and allograft (donor tissue) is sometimes added to make the graft more robust.
Allograft (Donor or Cadaver Tendons)
Allografts have the benefit of being very flexible, and grafts can be chosen with or without bone blocks, and in multiple sizes and configurations. It also makes the surgery quicker since there is no time spent harvesting autograft, and there is no harvest site pain after surgery.
However, strong research has demonstrated that using allograft in young patients (teens and 20’s) can result in a significantly higher graft failure rate than using autograft. For this reason, we typically don’t use allograft in young patients, except in specific situations, such as revision cases or where there is not a good autograft option. In slightly older or less active patients it is still a reasonable option.
ACL Surgery Facts
- Timing of Common ACL Postoperative Milestones
- ACL Functional Progression
- ACL Rehabilitation and Non-operative Protocols
FAQ. Frequently Asked Questions
Introduction
ACL surgery is a common procedure for those with a torn anterior cruciate ligament. It’s a crucial step towards regaining mobility and returning to an active lifestyle. In Baton Rouge, Dr. Jeremy Burnham is a trusted name in ACL reconstruction. His expertise and personalized approach make him a top choice for patients seeking this surgery.
Choosing the right surgeon is vital for a successful outcome. The surgeon’s skill and experience can significantly influence the surgery’s success and the patient’s recovery time. This guide aims to answer your questions about ACL surgery in Baton Rouge. It covers everything from the types of ACL surgery techniques to the role of physical therapy in recovery.
We’ll also delve into the risks and potential complications of ACL surgery. This information will help you make an informed decision about your treatment.Lastly, we’ll discuss how Dr. Burnham personalizes each patient’s ACL surgery and recovery plan. This tailored approach ensures the best possible results for each individual.
What is ACL Surgery?
ACL surgery repairs or reconstructs a torn anterior cruciate ligament, which is a key stabilizer in the knee. This ligament is often injured during sports or activities involving sudden stops or pivots.
The procedure involves reconstructing the torn ligament, usually with tissue grafts. These grafts can come from your body (autograft) or a donor (allograft). The choice depends on various factors, including age, activity level, and personal preference.
The primary goal of ACL surgery is to restore knee stability and function. Successful reconstruction allows patients to return to their daily activities and sports with confidence and reduced risk of future injuries.
Understanding the surgery’s basics helps patients have realistic expectations about recovery and long-term outcomes. With advanced surgical techniques, most patients experience significant improvements.
What Are the Different Types of ACL Surgery Techniques?
ACL surgery offers various techniques to suit different needs. The main goal is to restore knee stability and function effectively. The choice of technique depends on factors like injury severity and patient lifestyle. Some common ACL surgery techniques include:
Autograft: Uses a patient’s own tissue, like the patellar tendon.
Allograft: Involves grafting with donor tissue, suitable for those less active.
Arthroscopic Surgery: Minimally invasive, using a camera for precision.
Dr. Burnham evaluates each patient’s situation to recommend the most appropriate technique. This personalized approach ensures optimal outcomes and a tailored recovery plan.
How Long is the Recovery After ACL Surgery?
The recovery timeline for ACL surgery varies among patients. Usually, the process spans several months, with gradual progress up to a year or 18 months.
Physical therapy plays a crucial role, beginning shortly after surgery. Patients often regain full activity levels within six to nine months. Most patients return to full duty work around 3-4 months, and are cleared to return to high demand sports around 9-12 months.
Factors influencing recovery include the chosen surgical technique and adherence to the rehabilitation plan. A patient’s age and overall health are also essential considerations.
Consistent follow-up with Dr. Burnham ensures recovery is on track. Regular check-ins allow for timely adjustments to the treatment plan if needed.
What Are the Risks and Potential Complications of ACL Surgery?
ACL surgery, like any medical procedure, carries some risks. Understanding these helps patients make informed decisions.
Some common risks and potential complications include:
Infection at the surgical site
Blood clots
Knee stiffness or limited range of motion
Persistent knee pain
Re-injury to the ligament
Discussing concerns with Dr. Burnham is crucial. He provides comprehensive information to minimize risks and optimize recovery outcomes. Regular follow-ups help identify any early signs of complications, ensuring prompt intervention if needed.
How Do I Prepare for ACL Surgery?
Preparation for ACL surgery is key for a smooth process and recovery. Begin by understanding the procedure and discussing any concerns with Dr. Jeremy Burnham.
Patients should follow pre-surgery instructions carefully. These may include adjusting medications, planning for transportation, and organizing post-surgery support at home.
Maintaining a balanced diet and regular exercise can improve surgery outcomes.
Strengthening the muscles around the knee before surgery may aid in faster recovery.
Dr. Burnham will also advise on what to expect, helping to ease any anxiety. Having a clear plan and understanding the process ensures a more confident approach to surgery day.
What Role Does Physical Therapy Play in Recovery?
hysical therapy is vital after ACL surgery. It aids in restoring knee function and mobility. Early rehabilitation can minimize stiffness and swelling.
Therapists guide patients through exercises tailored to their recovery stage. This improves strength and flexibility. Gradual progression helps patients regain confidence.
Each recovery plan is personalized. The focus is on safe movements and long-term knee health. Dr. Burnham collaborates with therapists to ensure patients have the best possible outcomes. Regular therapy sessions are crucial for successful rehabilitation and returning to daily activities or sports.
What Are the Success Rates of ACL Surgery?
ACL surgery boasts high success rates, typically over 90%. Patients often experience significant knee stability post-surgery. This procedure allows individuals to return to their pre-injury activity levels.
Success, however, depends on several factors. These include the surgeon’s expertise and patient’s adherence to rehabilitation protocols. Complications are rare but can affect outcomes. Dr. Burnham’s thorough approach ensures patients understand their unique prospects.
Many patients resume sports and daily activities within months. Continued care and therapy optimize long-term success. The commitment to rehabilitation is crucial for reaching one’s personal recovery goals.
Can I Return to Sports After ACL Surgery?
Yes, many athletes successfully return to sports after ACL surgery. Recovery involves a dedicated rehabilitation process. This process restores knee strength and flexibility needed for sports activities.
Dr. Burnham devises tailored recovery plans for each patient, facilitating a quicker return to sports. The timeline can vary, usually ranging from six to nine months before full athletic participation. Commitment to rehabilitation, along with a gradual increase in activity intensity, enhances recovery outcomes. Regular follow-ups and a strong focus on knee care post-surgery are vital to ensure stability and prevent future injuries.
How Does Dr. Burnham Personalize My ACL Surgery and Recovery Plan?
Dr. Burnham acknowledges that every patient’s needs are unique. This understanding shapes his approach to ACL surgery and recovery. He starts with a thorough pre-operative evaluation to identify specific concerns and goals.
He combines advanced diagnostics with patient input to tailor the treatment plan. This ensures the surgical technique and recovery routine fit the patient’s lifestyle. Customized rehabilitation programs focus on individual progress, monitoring improvements meticulously. Dr. Burnham’s emphasis on personalized care aims to optimize recovery, ensuring patients return to their daily activities with confidence. This bespoke approach enhances outcomes and patient satisfaction.