Surgery for Anterior Cruciate Ligament Deficiency in Children and Young Adults.
Edited By: Gregory A. Schmale, M.D.
Last updated Wednesday, January 12, 2005
About the procedureTechnical details When anterior cruciate ligament (ACL) deficiency is a result of
fracture, surgery is designed to align the fracture fragments and keep
them from displacing (being moved from their natural position). The
fracture fragments may be held with suture, screws, or a combination of
the above. The knee is often casted in extension to help hold the
fracture fragments together.
ACL reconstruction is typically performed when there is an
intrasubstance tear (partial tear or stretching injury) of the
ligament. Reconstruction is performed with hamstring autografts
harvested from the same knee.
After the knee is examined arthroscopically, the graft is harvested
thru a three to four centimeter incision just off the midline below the
knee joint. Two tendons are harvested and sutures are placed through
them for passage up through the knee. Holes are drilled in the tibia
and femur to accept the graft, and it is held in place in the femoral
tunnel with a button. The graft is then tensioned and fixed to the
tibia by a screw and washer. The hardware is designed to stay in a
lifetime, though if the patient has a reaction to the hardware, it can
be removed after about one year.
The wounds are closed with suture and the knee is placed in a knee
immobilizer or hinged knee brace after a cold cuff is applied. The cold
cuff provides cooling therapy directly to the knee, aiding in
post-operative pain relief. Anesthetic Usually general anesthetic is employed for ACL reconstruction
surgery. An epidural catheter may be placed to help with post-operative
pain control. Another treatment alternative is placement of a femoral
nerve block to aide in post-operative pain relief.
Surgery for Anterior Cruciate Ligament Deficiency at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-987-3700 to make an appointment.
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