Anterior Cruciate Ligament (ACL) tears are a common knee injury to those playing physically demanding sports such as football and soccer. Basketball players also suffer from this injury due to the abrupt stopping and starting on the court. Knee pain from ACL tears range from mild to incapacitating, and recovery time depends on the severity of the injury. Not all tears require surgery, but it is often used to give the patient full knee functions. There are three bones that meet together to form the knee. The femur (thighbone), patella (kneecap), and the tibia (shin). The kneecap actually sits in front to provide protection and it is what we can immediately feel when grasping the knee. Bones and joints are held together by ligaments: the lateral collateral, medial collateral, posterior cruciate, and the anterior cruciate. These ligaments work together to control the motion of the knee. The anterior cruciate is in the middle and runs diagonally. This ligament keeps the shin from moving ahead of the thighbone, along with giving it stability while it rotates. When the ACL tears, the shinbone is not stable, and full range of motion is lost.
Two different Surgery
There are two different surgery options in regards to ACL reconstruction: autografts or allografts. Autografting is the process of grafting tissue from one place to another within the same body. These are the most common types of ACL reconstruction surgery, which include the options to graft the patellar, hamstring, or quadriceps tendons, the patellar being the most performed procedure. Allografts, which is the process of grafting tissue donated from another person, have been on the rise in the last 15 years, and those have the option of using patellar or Achilles tendon tissue. Most Orthopedic surgeons believe that the type of grafting used in an ACL tear is extremely important in regards to recovery and function. However, once a tear has been grafted, a second grafting does not give the surgeon as many options as he would when performing the initial reconstruction. To determine the revision success rate of allografts versus autografts, a study was conducted on 1205 patients, with the median age of 26 years, and 58% of them being male. First revisions were conducted on 88% of the patients, with 28% of the patients using the same surgeon who did their first reconstruction. An autograft revision was performed in 48% of the patients, an allograft was performed on 49% of the patients, and the remaining had both types performed. After two years the patients had a follow up to find out the outcome of their surgery. Only 3% of the patients had a graft rerupture which occurred from a total of 24 allografts, 12 autografts, and 1 combination surgery. Patients with autografts were 2.78 times less likely to have reruptures compared to those who had an allograft. This data was not surprising to surgeons who believe that autografts are superior to allografts, and this data will be used for furthering ACL education. If you have been told you have an ACL tear or are suspicious of one, contact our highly specialized and award winning orthopedists at Orthopedic Surgery San Diego to care for you.