ACL Repair

What is it: ACL reconstruction is surgery to rebuild the ligament in the center of your knee with a new ligament. The anterior cruciate ligament (ACL) keeps your shin bone (tibia) in place. A tear of this ligament can cause your knee to give way during physical activity.

Important Facts: The procedure is usually done by knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.

Statistics: Statistics show that more than 60% of patients diagnosed with an ACL tear also have a torn meniscus. Statistics also show that female athletes have a 25% chance of tearing their ACL a second time after having the reconstruction surgery done. The average cost for surgical repair of an ACL tear is approximately $11,500. If all ACL injuries were repaired, the associated expenditure for 100,000 procedures would eclipse $2 billion annually. ACL injury rates are estimated to be 2-8 times higher in women than in men. Not a single report of mortality was found in 6 different studies examining the morbidity and mortality of anterior cruciate ligament repair.

Treatment Duration: You will need to stick to a program for 4 to 6 months before you can return to full activity. The success of the surgery depends on how well you stick with your rehabilitation program.

Do’s/Don’ts: Don’t cheat on the rehab.

Common Myths: Bone-patellar tendon-bone is the strongest and stiffest graft. Bone-patellar tendon-bone (BPTB) is one-half the strength of double-looped semitendinosus and gracilis (DLSTG). The literature concludes that the double-looped semitendinosus and gracilis is the strongest and stiffest graft.

Myth: Interference screw fixation of a bone patellar tendon-bone (BPTB) graft is the “gold standard “for ACL reconstruction.

Fact: The strength of BPTB fixed with interference screws is 416N.1

Fact: DLSTG fixed with Bone Mulch™ Screw and WasherLoc™ strength is 903N.7

Fact: The stiffness of BPTB fixed with interference screws is 51N/mm.1

Fact: DLSTG fixed with Bone Mulch™ Screw and WasherLoc™ stiffness is 208N/mm.

Fact: Slippage of BPTB graft fixed with interference screws is an excessive 3.8mm at 500N.2

Fact: DLSTG fixed with Bone Mulch™ Screw and WasherLoc™ slippage is .8mm in porcine bone. DLSTG fixed with Bone Mulch™ Screw and WasherLoc™ slippage is 1.8mm in human bone.3