ACL Surgery

The anterior cruciate ligament (ACL) is a ligament in the knee that prevents the tibia from sliding forward relative to the femur. It is an important stabilizer in the knee. The ACL can be injured during a pivot, when the foot is planted and the knee twists, or when landing awkwardly from a jump. Also, female athletes are 3 times more likely to sustain an ACL injury compared to males.

Symptoms of an ACL tear may include:

• Feeling or hearing a popping noise in the knee
• Pain on the outside and back of the knee
• Immediate and significant swelling within the first few hours of the injury
• Limited knee movement because of pain or swelling or both
• The knee feeling unstable, buckling, or giving out

If you have been told that you may need ACL Reconstruction, here are 4 important things you should know…

1. How Traditional ACL Surgery is Performed

With typical ACL Reconstruction, multiple holes are drilled through the knee to allow for the implantation of a portion of the patients own patellar tendon or two hamstring tendons (Autograft) or a piece of material from a cadaver (Allograft). These implants are used to strengthen the torn ACL.

According to multiple studies, Allografts have been shown to have a higher re-tear rate, especially in younger patients. Therefore, the most common choice has been the Autograft, which has included either the use of two separate pieces of the hamstring tendon or the use of the patellar tendon and a small piece of bone from the kneecap. Although this traditional approach has been the most common, it has several drawbacks and limitations.  The most important of these limitations has been the need to make several incisions into the knee to complete the procedure.  Another important limitations of this traditional approach can include:

• Larger incisions
• Multiple incisions into the knee
• Increased postoperative pain
• Decreased range of motion in the knee
• Increased incidence of osteoarthritis in the knee

2. The More Innovative “All Inside” Approach

Recently, a newer and more advanced procedure, known as the “All Inside” approach has changed the way in which ACL Reconstruction is performed.  This approach utilizes only one small incision on the knee to harvest a single hamstring tendon which is then folded to make a graft that is typically larger than the classic two hamstring graft. Also as important, the All Inside approach does not require the drilling of holes through the entire knee to place the graft. Instead, a small hole is made only part way through the tibia to place the graft, which has been shown to have decreased post-operative pain.  Several studies have shown that this more advanced approach results in:

• No large incisions on the knee
• Re-establishing of leg control
• Restoration of normal range of motion
• The harvesting of only one hamstring tendon
• Walking without a limp sooner
• Decrease in post-operative pain
• Restored normal stability in the knee

Due to these benefits, the All Inside approach has become ideal for athletes as well as those who wish to maintain an active and healthy lifestyle.  Furthermore, studies have shown that this approach is as effective as traditional ACL Reconstruction. At Total Orthopedics and Sports Medicine, our Knee Specialist are pioneers in the utilization of the All Inside approach.

3. ACL Reconstruction Can Be Performed As an Outpatient Procedure

As a result of advancements in surgical techniques and technology, all of our ACL Reconstruction procedures can be performed as outpatient procedures by the Total Orthopedics and Sports Medicine team. Patients are evaluated after surgery and once they are comfortable, they can be discharged and are free to recuperate in the comfort of their own home. A post-operative exam is scheduled a few days after surgery and a physical therapy protocol is established.

4. Physical Therapy is Important

After surgery, the most important goal is to regain the strength in the quadriceps muscles. At Total Orthopedics and Sports Medicine, our specialists develop and design specific Physical Therapy treatment plans for each patient utilizing our physical therapy team. Each patient is given a protocol that suits their lifestyles and goals to ensure the best possible post-surgical outcomes.

Exciting new technology has helped in the assistance of recovery including a post-operative brace that utilizes electrical stimulation to decreased pain in the early post-operative period and increased quadriceps strength. Total Orthopedics and Sports Medicine is at the forefront of orthopedic surgery and is one of the first in the NY area to utilize this technology.

At Total Orthopedics and Sports Medicine, our Knee Center is led by renowned experts Dr. Charles Ruotolo, Dr. Richard McCormack, Dr. Brett Spain and Dr. Paul Pipitone.   Our experts utilize pioneering approaches to treat ACL injuries using the latest advancements in arthroscopic surgery.  Together, they comprise one of the most awarded and respected orthopedic groups on Long Island.

If you, or someone you love, is considering an ACL Surgery, contact us today to schedule a consultation at one of our offices located throughout Suffolk and Nassau County, Long Island.