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ACL Reconstruction

Dr. Lonnie Paulos is one of the leading orthopedic surgeons in this country. With over 30 years of experience, he provides advanced treatments for patients with an ACL injury.

The ACL (anterior cruciate ligament) is one of the most commonly injured ligaments of the knee. In general, the incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball, football, skiing, and soccer.

Immediately after the ACL is torn, many times from a non-contact cutting, twisting or pivoting action, you usually experience pain and swelling, and the knee feels unstable. Within a few hours after a new ACL injury, you often have a large amount of knee swelling, a loss of full range of motion, pain or tenderness along the joint line, and discomfort while walking.

Approximately 50 percent of ACL injuries occur in combination with damage to the meniscus, articular cartilage, or other ligaments. Additionally, you may have bruises of the bone beneath the cartilage surface.

When you come in for an evaluation, Dr. Paulos may take X-rays and perform special tests to help evaluate the ACL and check for evidence of other damage. If the ACL is torn, he will test the integrity of the ACL looking for a firm end point if the ligament is intact. If a firm end point is not felt, the ACL is not providing stability to the knee. Another test is the ACL pivot shift test. If the ACL is torn, the tibia will start forward when the knee is fully straight, and then will shift back into the correct position in relation to the femur when the knee is bent past 30 degrees.

The most fundamental problem following a tear of the ACL is that the knee is "loose." The normal ACL restrains the knee in a very small range, and this critical restraint is lost following a tear. If you are an active person, you place significant stress on your knees. Having reconstruction of the ACL is the best option to restoring stability to the knee and returning your mobility and normal life style.

Dr. Paulos has various techniques and may select certain different grafts to reconstruct the ACL. He uses an arthroscopic technique and recommends one of the three most commonly used grafts: the patellar tendon (bone-tendon-bone) graft, the hamstring tendon graft, and allograft (donor tissue); all have their various advantages and disadvantages. At this point, there is no strong evidence to suggest that one of these grafts is better than the other. However, for certain patients, a particular graft may be recommended to avoid the potential disadvantages that another type of graft may cause.

A specific, post-operative rehabilitation program, based on the graft type selected, begins within one or two days of surgery. Goals to reach in the postoperative recovery process are full range of motion by four weeks, jogging by three months, and return to sports by six months.

If you would like to discuss your knee pain with Dr. Paulos, please call our office today so we can make an appointment for an examination.