What is ACL Reconstruction?
This procedure replaces a damaged or torn anterior cruciate ligament (ACL) in the patient’s knee with a portion of the hamstring tendon. The ACL connects the front top of the tibia (lower leg bone) to the rear bottom of the femur (thigh bone). The hamstring tendons attach the hamstring muscles to the lower leg.
Autograft Prepared
Through a small incision below the knee, portions of the hamstring’s semitendinous and gracilis tendons are separated from the muscle but left connected to the tibia. These strips are braided together to create a section of tendon called an autograft, which will be used to replace the damaged ACL.
Torn ACL Removed
The rest of the procedure is performed through small incisions on the sides of the knee. The surgeon uses a small video camera called an arthroscope to see inside the knee during the procedure. With the knee flexed, the damaged ACL is cleared away.
Guide Pin Inserted
A pin is inserted diagonally, from the tibia to the femur. The orthopedic surgeon will use the pin as a guide to recreate the ACL.
Tunnel Created
The surgeon follows the guide pin, drilling a tunnel through the tibia and femur.
Horizontal Screw Inserted
A second tunnel is drilled to intersect with the femoral tunnel, and a horizontal screw is partially inserted. The hamstring grafts will be looped over this screw.
After the Procedure
The patient will have to go through physical therapy exercises. After the pain and swelling is gone, and there is full range motion with the knee, this may be a sign that the use of the leg has been fully restored. Then the patient will be able to use that leg and return to playing sports.
If you’d like to learn more about ACL reconstruction without hamstring, there is more information about that procedure on our website.