People typically tear their ACL (anterior cruciate ligament) when they stop suddenly, change direction abruptly, or land incorrectly from a jump. It’s one of the most common knee injuries and often occurs in athletes who play twisting sports like basketball, football and soccer.
Physical rehabilitation can help people walk after an ACL tear, and older adults who are less active may be able to recover without surgery. Most active people, however, benefit from ACL reconstruction. Knees with untreated ACL tears run the risk of further damaging the meniscus and cartilage in the knee.
ACL Surgery: Autograph vs. Allograft
Your surgeon reconstructs the ACL by grafting a piece of tendon onto the knee where your ACL was torn. The tendon is fixed to the bone with biodegradable screws or buttons. Usually—95 percent of the time—the body reestablishes blood supply to the grated tendon.
There are two types of grafts:
- Autograft ACL reconstruction: Tendons such as the patellar tendon and hamstring tendon are taken from your own body and used for the graft. The main advantage of autographs is that you use tissue from your own body. The disadvantage is that you may suffer some pain, weakness, fracture, or scarring where the graft tendon was harvested.
- Allograft ACL reconstruction: Tendons are taken from human donors rather than your own body. The primary advantage of allograft tissue is that there is no additional damage to the knee and stronger grafts can be used. However, there is a very small chance of disease transmission, and these grafts may stretch out in younger patients.
Orthopedic surgeons at the Palo Alto Medical Foundation are experienced and expert in performing ACL reconstruction with minimally invasive surgery called arthroscopy. Our goal is to get you back in the game.
Knee arthroscopy is minimally invasive surgery that allows your doctor to repair certain painful knee injuries and problems using very small incisions. Arthroscopic surgery on the knee results in faster, easier recovery than traditional open surgery.
Our orthopedic surgeons are expert and experienced in knee arthroscopy. They usually perform the procedure in one of our outpatient surgery centers so patients do not need to spend a night in the hospital.
During knee arthroscopy, your doctor inserts a small telescope called an arthroscope into your knee through an incision about the width of the top of a straw. Images of the inside of your knee are projected onto a computer screen. Your doctor makes one or more small cuts to insert miniature surgical tools that can shave, trim, stitch or smooth the damaged area of your knee. The doctor views the inside of your knee on the computer screen throughout the surgery.
Knee arthroscopy may be used to treat many problems with the cartilage, ligaments and soft tissue in the knee, including:
- Cartilage restoration
- Loose fragments of bone or cartilage in the knee joint
- Meniscal tears
- Realignment of the patella (kneecap) with lateral release
- Reconstruction of a torn anterior cruciate ligament (ACL)
- Synovial tissue inflammation
Many people return to most physical activities within six to eight weeks after knee arthroscopy, although your recovery depends on the damage to your knee before surgery. Some people may need to modify high-impact activities such as running, and switch to low-impact exercise such as swimming or bicycling. Your doctor will outline the best activities for you.
Total and partial knee replacements offer hope and concrete results for people living with chronic pain and disability. The surgery can ease pain and restore function to most people. Still, choosing knee replacement surgery requires careful planning and consideration. PAMF orthopedists support you every step of the way.
Our surgeons are highly skilled and trained in the latest techniques, resulting in less scarring and faster recovery. Today, knee replacements last decades, improving the lives of many as we age. But it is important to have realistic expectations. After you recover from surgery, you should be able to do the activities you could do before your joint replacement, with less pain. The surgery won’t fix problems unrelated to joint pain.
During a knee replacement, your surgeon removes damaged cartilage at the ends of the femur and tibia bones, along with a little bit of the underlying bone. Then the surgeon inserts metal parts that recreate the surface of the joint. The parts are either cemented or pressed into the bone. Sometimes, but not always, the underside of the kneecap is cut and resurfaced with plastic. Lastly, the surgeon inserts a plastic spacer between the metal parts to create a smooth gliding surface.
Joint replacement operations are successful and long-lasting for more than 90 percent of patients. Nevertheless, joint replacement is major surgery, and like any such procedure, carries risks and potential complications. Your surgeon will discuss these risks with you at your initial consultation.
Causes of Knee Pain
- Osteoarthritis is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older and especially in individuals who have a family history of arthritis. The cartilage cushioning the bones of the hip gradually wears away causing bones to rub against each other, resulting in knee pain and stiffness.
- Rheumatoid arthritis is an autoimmune disease in which the synovial membrane becomes inflamed and thickened. This chronic inflammation can damage the cartilage, leading to pain and stiffness.
- Post-traumatic arthritis can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.