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Orthopaedic Surgeon Richard Villar talks about surgery for anterior cruciate ligament injury.
Mr Richard Villar Orthopedic Surgeon
Mr Villar is one of the top Orthopedic Surgeons in the World. As former Surgeon to the British Army Special Air Service Regiment he has practiced medicine in some of the most remote and challenging environments. Here he talks exclusively to Sportsinjuryclinic.net about ACL reconstruction.
Firstly the diagnosis should be confirmed with manual tests and MRI scans. Previously extra-articular operations were undertaken which means tightening a tendon from outside the knee joint to stabilise the joint, rather than repairing the ACL itself. The majority of operations are now Intra-articular reconstructions where a graft is used from either the patella tendon, or the semitendinosus (hamstring) tendon. These are known as bone-tendon-bone grafts as the graft of tendon is attached to bone 'plugs' at each end. Artificial ligaments and donated ligaments are also occasionally used.
Who should have surgery?
It was previously believed that the ACL did not play a hugely important role in stabilising the knee joint and so ruptured ligaments may have been removed. This now does not occur as the importance of the ACL in knee joint stability is now fully understood. However, surgery is not undertaken in every case. The decision to forego surgery is based on the stability at the knee, the patients age and the activities or occupations they are involved in. Many people choose to try to stabilise the knee by building up muscle strength, especially in the Quadriceps. In addition, knee braces which work to prevent rotation can also be used. These are particularly popular in high impact activities such as skiing.
Recovery from ACL surgery
Recovering from ACL Surgery and ACL reconstruction is extremely variable, but generally it can be expected that within 4-5 months the knee is starting to function normally and kicking movements and sudden turns may be possible. Even 1 year post surgery the knee may feel almost normal but total perfection is rare, it may still result in minor niggles every now and again.