1. Anatomy and Function:

          The Anterior Cruciate Ligament (A.C.L.) is the most important ligament in the knee. It joins the femur to the tibia at the center of the joint and prevents shifting movements during activity.
 

2. Injury:

            The A.C.L. is injured when the knee is twisted under load, angled to the side or  hyper-extended. This can   occur during a fall, rapid deceleration, pivot or collision. The ligament usually ruptures or tears at  it's mid   portion which renders it non- functional and creates an unstable knee.
 

3. Treatment:  
                    
          The torn A.C.L. has very poor healing potential and therefore cannot be repaired. The choices are: 
                  1) replace the ligament or 
                  2)live without an A.C.L. The following criteria are used to arrive at a decision: 


                   a) Patient age
                   b) Activity goals
                   c) Associated injuries
                   d) Degree of instability

NON SURGICAL  
     
         Treatment begins with rehabilitative exercises to strengthen the leg followed  by the use of a
        custom knee brace for all strenuous activities

SURGICAL

           Treatment consists of an arthroscopic procedure to replace the torn A.C.L. First, the entire knee is examined to identify torn cartilage or other problems that need to be addressed. Then the torn A.C.L. is removed and the area
          is prepared to accept a tendon graft replacement. The choice of graft includes:

a) Patellar tendon 

b) Hamstring tendons 

c) Cadaver tendons



Anterior Cruciate Ligament Injury

What are the anterior cruciate ligaments?

The knee can be thought of as having four ligaments holding it in place, one at each side to stop the bones sliding sideways and two crossing over in the middle to stop the bones sliding forwards and backwards. It is the latter two in the middle that are called the anterior cruciate ligaments, the posterior (meaning back) anterior cruciate ligament and anterior cruciate ligament (meaning front). If damaged they may cause knee pain.




press play to see a short narrated slide show of an ACL Reconstruction
Anatomy and Function

Anterior Cruciate Ligament

          Dr Yacobucci has performed over 3000 of these A.C.L. reconstructions and uses state of the art techniques and instrumentation. He has extensive training in this area and is actively involved in clinical research related to this procedure.

          The surgery is performed as an outpatient procedure and lasts about two hours. The patient begins rehabilitation almost immediately and gradually increases thier activities untill full recovery ia achieved at 9 months with brace post- op.

          This operation, although extensive, will restore the knee to over 95% of it's pre-injury function.