ACL Injuries - Treatment: Operative

Patients for whom surgery is generally recommended:

  • Active individuals who participate in any sport with pivoting - such as soccer, tennis, basketball, football, or skiing
  • Patients who continue to experience instability after going through a rehabilitation program
  • Those with injuries involving more than one ligament
    It is important to consider the patient's commitment to the rehabilitation program following an ACL surgical procedure. This is especially critical if a meniscal repair is also required. The patient must agree to carefully follow the recovery timetable outlined by the doctor.

The timing of an operation is important to prevent stiffness after surgery and obtain the best results. It is helpful when:

  • range of motion is adequate
  • swelling is reduced
  • quadricep muscles are functional
    It often takes about three weeks for the knee to reach this point.

Is there a simple way to repair the damaged ACL without a reconstruction?

In a direct repair the ends of the torn ligament are sewn together. This procedure is usually not recommended, as the ends of the ligament do not heal reliably. Direct repairs of the ligament to the bone may heal; however, this, also is not always reliable.

Extra-articular (outside the joint) procedures involve securing a portion of a tendon on the outer part of the knee (the iliotibial band) across the outside of the joint. This procedure does not reconstruct the torn ACL. It attempts to provide increased stability by placing a restraint on the outside of the knee. This procedure is generally not adequate by itself but it is occasionally done to provide additional support after ACL reconstruction.

Replacing the damaged ACL with a graft made of synthetic materials is no longer performed due to poor results. Many patients who had this surgery experienced reactions to the synthetic material as well as early failures of the graft.

An ACL reconstruction is the most common surgical procedure performed today since it usually produces the best results.


About Doctor Barrow...

Dr Michael Stuart Barrow is an Orthopaedic Surgeon who specialises in knee surgery. He practices from Sunninghill Hospital and the Waterfall Sports Centre.
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Contact Details

Dr. Michael Barrow

Tel: 011 806 1772/0 and 011 806 1657
Fax: 011 806 1796
Cell: 082 925 4940

After Hours:
Sunninghill Casualty: 011 806 1652

Sunninghill Hospital
Suite 5, East Wing
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