Sports Medicine

August 25, 2015

I Tore My ACL, Now What? Your ACL Reconstruction and Surgery Options


ACL tears are painful knee injuries that may require surgical treatment. ACL reconstruction surgery using tendon grafts can help restore your knee’s stability.

Roughly 200,000 people in the US injure the anterior cruciate ligament (ACL) in their knee each year. Your ACL keeps your knee joint stable and allows its full range of motion. When your ACL is partially or completely torn, you will have trouble putting weight on the affected knee, as well as bending and extending it fully. In some cases, you may need an ACL reconstruction to repair your injured ligament.

Types of ACL Injuries
ACL tears can range in severity depending on the depth of the tear, where the tear is located, and if surrounding ligaments sustained damage. Most ACL injuries fall into one of these categories:

  • Partial Ruptures: Partial ruptures occur when the ACL tears without breaking. If the knee is still stable, your doctor may suggest nonsurgical treatment methods, such as knee braces and physical therapy, before considering surgery.If your pain continues or worsens, or if you do not regain your range of motion, discuss your treatment options with an orthopedic surgeon.
  • Partial Ruptures with Instability: If you suffer a partial ACL rupture that tears deeply or close to your kneecap, your knee may become unstable. Instability can cause further damage to your knee by putting pressure on the wrong joints and tendons, which causes you to fall. If your ACL rupture causes knee instability, your surgeon may recommend ACL reconstruction to protect you from further damage.
  • Complete Ruptures: A complete rupture of your ACL means that your tendon was fully severed and can no longer aid your knee supporting your full weight. A complete rupture requires surgery to restore your full range of motion.
  • Ruptures with Damage to Surrounding Areas: Roughly, 50% of all ACL injuries involve damage to other nearby tendons, muscles, and joints. Multiple injuries mean less compensation from surrounding muscle and tendon groups, putting even more stress on your damaged ACL. An orthopedic surgeon can explain what the best ACL surgery graft options are to repair the damaged areas.

ACL Reconstruction Options
An ACL surgery does not use sutures to repair your ACL tear because moving and stretching your ACL daily can cause sutures come loose very quickly. Instead, ACL reconstruction uses a graft taken from your surrounding tendons’ tissues to repair your torn ligament.

The type of graft used depends on the extent of damage to your ACL, your activity level, and your age. ACL surgery graft options include:

  1. Bone-Patellar Tendon Autograft – This graft option uses part of your patellar tendon and a small piece of your shinbone and kneecap to reconstruct your This type of graft surgery is associated with high success rates, making it popular among orthopedic surgeons in Arkansas for treating partial and complete ruptures.
  2. Hamstring Tendon Autograft – For this surgical procedure, part of the hamstring tendon is used to create an autograft. In some cases, part of the gracilis tendon—located below the knee—is also used. Hamstring autografts typically have a quicker recovery time and a lower risk of stiffness and kneecap pain than other ACL surgery graft options.
  3. Quadriceps Tendon Autograft – A quadriceps autograft uses part of your quadriceps tendon and a piece of your kneecap to make an autograft. Your quadriceps tendon and kneecap are larger than your hamstring tendon and patellar, which means a larger graft can be taken. This option is recommended when you have sustained extensive damage to your ACL.
    Quadriceps tendon autografts are also used for patients who have previously undergone an unsuccessful ACL reconstruction.
  4. Allograft – An allograft uses grafts taken from a deceased donor, rather than your own tendons. Allografts are recommended when more than one ligament in your knee needs to be repaired—requiring more tendon tissue to repair the damage than can be safely removed from your own tendons.
    Because no grafts are being taken from your surrounding tendons, allografts require smaller incisions than the other surgical graft options. Less invasive surgery means that your recovery time will be quicker and less painful, although it is possible that your body will reject the donor graft. Discuss your risk of rejection with your orthopedic surgeon.

ACL injuries can worsen over time without proper medical attention, so find an experienced orthopedic surgeon to discuss your treatment plan and surgical options as soon as possible.

For more information on ACL reconstruction in Arkansas, contact Arkansas Surgical Hospital at
(877) 918-7020 to schedule an appointment with one of our renowned orthopedic surgeons.

*Photo courtesy of Zach Taylor through Flikr CC 2.0

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