Understanding ACL Reconstruction

The anterior cruciate ligament (ACL) is located in the front of the knee and crosses in front of the posterior cruciate ligament (PCL). The ACL is the most commonly torn ligament in the knee, particularly among athletes and active individuals. Due to involvement in running, sudden direction changes, and abrupt stops, athletes are at a higher risk of ACL injuries. ACL reconstruction surgery is often required to restore stability and full function to the knee.

What is an ACL Tear?

The ACL's primary function is to prevent the shinbone (tibia) from moving too far forward in relation to the thighbone (femur). During an injury, the ligament may be stretched beyond its range, causing a mild stretch or a complete tear. Many patients report hearing a "popping" sound at the time of injury, followed by pain and swelling.

Treatment Options for an ACL Injury

Due to the poor blood supply and complex knee anatomy, the ACL cannot heal on its own. While non-surgical treatments such as physical therapy may be prescribed in some cases, most active individuals opt for ACL reconstruction to return to their previous activity level.

Does an ACL Tear Require Surgery?

If surgery is required, ACL reconstruction is the standard treatment. The procedure involves:

• Examination: Dr. Khaleel, Senior Consultant Arthroscopic Knee and Sports Surgeon at Kims Alshifa, Perintalmanna, Kerala, India, inspects the knee joint using an arthroscope (tiny camera).
• Removal: Damaged ligament ends and soft tissue debris are removed.
• Reconstruction: The torn ligament is replaced using a graft (either autograft from the patient or allograft from a donor).

Treatment Options for ACL Surgery

There are two primary ACL reconstruction techniques used by Dr. Khaleel:

1. SAMBBA Technique

This method preserves ACL remnants and uses Hamstring grafts for reconstruction. The ACL graft is fixed with absorbable screws to promote natural biology and healing. This technique was pioneered in France and learned by Dr. Khaleel at the Lyon School of Knee under Dr. Sonnery-Cottet.

2. Press Fit ACL Reconstruction

This technique is used for chronic ACL tears and employs a bone-patellar tendon-bone (BPTB) graft. It is a time-tested method with the advantage of no implants on the femoral side.

Selecting the Appropriate Graft

The choice between an autograft (patient’s tissue) and an allograft (donor tissue) depends on the patient's specific needs and lifestyle. Dr. Khaleel carefully evaluates each case to determine the best graft type, surgical approach, and post-operative rehabilitation plan.

Dr. Khaleel ensures individualized treatment for every patient, helping them recover and return to normal activities with improved knee function and stability.