ACL RECONSTRUCTION SURGERY

• anyI have a specialist interest in ACL injuries and their treatment. I have published a number of key research areas helping athletes return to sport successfully. 
• Surgery is an important part if the process but the pre-operative optimisation and post-operative rehabilitation are just as important. I perform a reconstruction that allows maximum acceleration in the physiotherapy stages:

Surgical steps

• The damaged intra-articular ACL is removed and reconstructed with a graft.
• This is combined with a knee arthroscopy to guide the procedure and allow any other associated injuries in the knee to be treated at the same time, such as meniscal or cartilage damage
• The graft is made by taking a section of tissue from around the knee, most commonly a hamstring tendon from the back inside of the knee or a strip of patella tendon from the front
• Bone sockets hold the intra-articular graft in place which is then tensioned with permanent buttons that sit snug onto the outside of the bone.
• This may need to be combined with a second reconstruction on the outside of the knee for added control of knee stability

Rehabilitation

• The surgery is just one part of a usually 9-month return to sport programme with a multidisciplinary team of experts that work with me to guide you back to full sporting function. 
• I work with the best local physiotherapists and allow rehabilitation that is accelerated and matched to your performance levels
• The aim is to minimise swelling, regain early full range of knee motion, and prevent any muscle loss.
• Review my insights in a talk on this subject uploaded in the BLOG

Other knee ligament repairs and reconstructions

• Whilst the ACL is the most commonly injured knee ligament that requires surgery, there are 3 other main regions of the knee that can sustain ligament injuries:
  • Medial collateral ligament (MCL)
  • Lateral collateral ligament (LCL) and the posterolateral corner (PLC)
  • Posterior cruciate ligament (PCL)
• These ligaments can be injured individually or in combined multi-ligament injuries where each individual case has a tailor-made approach to repairing and reconstructing the knee

Revision ACL Reconstruction

•  I am often sent referrals where a previous ACL reconstruction has failed.
• There can be a number of reasons for a ruptured graft such as a return to sport too early, a failure to provide an environment for graft healing and integration, graft malpositioning, or simply another episode of sufficient force during sport.
• It is vital that the revision reconstruction learns from any previous mistakes and that the surgery provides maximum stability to allow bespoke physiotherapy.
• 3D imaging and weight-bearing full leg x-rays will help guide my surgery where I often offer different graft choices and always add in a lateral tenodesis.
• Post-op physiotherapy can often be the same fast protocols as seen in primary ACL reconstruction.