ACL Reconstruction: Choices Are Age- Dependent

ACL Reconstruction: Choices Are Age- Dependent

by Dr. Shailendra Patil

Posted on 13th May, 2023 at 5:33:40 AM


A torn anterior cruciate ligament (ACL) is very common in youngsters nowadays. It is more common in athletes as they exercise and stretches their body more than any normal person. There are multiple ways to treat torn ACL so the ACL reconstruction surgeon in Mumbai keeps in mind the age of the patient during treatment.

What is ACL?

Your knee has four major ligaments. The knee ligament called the anterior cruciate ligament (ACL) connects the thigh bone, or femur to the shin bone or tibia. There are various reasons for torn ACL, they might be:

  • If a person stops suddenly
  • If a person changes his movement of direction suddenly
  • If a person lands on a rough surface
  • Or if there is a collision of your knee with a hard surface.

These reasons are more common in sportspersons, in the majority of cases the ligament tears completely into two parts making the knee unstable and severe pain. Most of the time your doctor for ACL Surgery in Thane opts for the surgery keeping in mind the following reasons:

  • You are young and activity levels are high.
  • If you are a sportsperson and want to continue your game.
  • Your knee has additional damage.
  • You are feeling severe pain.
  • Not able to do regular daily activities.

An ACL that is severely torn may be surgically reconstructed with a graft so that your thigh and shin bones are connected with ligaments or tendons taken from another part of your leg. To do the procedure the torn ACL is removed and the graft is attached through holes the surgeon drills in the thigh bone and the shin bone. After the graft is passed through the holes it is held and placed with the help of screws or other devices. Incisions in your skin are closed with stitches, tape, or staples. Various tissues/grafts have been used to anatomically reconstruct the torn ACL.

There are 4 types of grafts:

Autografts are taken from the patient’s own body and include portions of the extensor mechanism, patellar tendon, iliotibial tract, semitendinosus tendon, and gracilise tendon.

Allografts: grafts taken from cadavers.

Xenografts: grafts taken from animals. Bovine xenografts in particular have been associated with a high complication rate.

Synthetics: These can be further classified into 3 categories, bio gradable (carbon fibers), permanent prostheses (Gore-Tex and Dacron), and ligament augmentation devices.

The most commonly used are the autografts (patellar bone & hamstring) and sometimes the allografts. There is no consensus in the literature as to which provides the most stability.  Each of these choices has advantages and disadvantages.

Why Age is an important factor?

Surgical reconstruction of ACL is dependent on the age of the patient and the type of graft that the patient has received. Young and active patients have more successful outcomes after the surgery. Generally, it is most common to have a successful outcome if your age is less than 40. But even if you are above 40 and do regular exercises and activities then the surgery will also be successful.

Successful ACL reconstruction paired with focused rehabilitation can usually restore stability and function to your knee. Within the first few weeks after surgery, you should strive to regain a range of motion equal to that of your opposite knee. Recovery generally takes about nine months.

It may take eight to 12 months or more before athletes can return to their sports.

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