ACL Surgery- Patellar Tendon Graft
The ACL repair is done by using a graft to replace the torn ligament after it is removed. There are two main types of grafts used in an ACL surgery, and autograft and an allograft. An autograft is a graft that is taken from the patients own tissue, for example the patellar tendon in this specific surgery. There are also several types of autografts that can be taken such as the quad tendon or the hamstring tendon, however the patellar tendon has proven to be the strongest. The other type, the allograft, is taken from a donor and in an ACL surgery is usually a cadaver patellar tendon.
The first incision is made to expose the patellar tendon in order to retrieve the graft.
An orthopaedic saw is then used to remove the center portion of the patellar tendon, including the upper and lower parts of the connecting bone. This allows for strong bone on bone healing.
The left and right portions of the patellar tendon are then stitched back together. The tendon will heal together and be just as strong as before.
Two small incisions are made on the left and right areas of the first. An arthroscope is inserted to look inside the knee and remove the torn ACL. This is a picture of the torn ACL on screen.
The portion of the patellar tendon that was removed is taken to the side to be prepared to become the patient's new ACL.
The knee is then prepared for the new ACL, and a hole is drilled in the tibia where it will be anchored with a screw.
The new ACL is pulled through the intercondylar notch on sutures.
The new ACL is anchored with a screw in the upper portion of the tibia and into the femur with an Endobutton.
The portion of bone that was removed from the knee cap is then filled with bone graft.
The patient is then stitched up and sent to recovery. They will stay overnight in the hospital to stay comfortable and minimize pain, and will begin therapy the following morning.