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:
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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 their activities until full recovery is achieved at 6 months post-op.
This operation, although extensive, will restore the knee to over 95% of its pre-injury function.
