Each year, approximately four hundred thousand people injure their Anterior Cruciate Ligament (ACL) severely enough to require reconstructive surgery. A report from Medical News Today reveals that eighteen to thirty-five thousand of these will fail and require additional surgeries for revisions. These revisions are complicated surgeries that are less successful and require more rehabilitation time than the initial surgery.
The ACL is a ligament in the knee that runs from the medial/anterior aspect to the lateral/posterior aspect. It provides support to knee joint. It also limits excessive rotation of the knee and forward extension of the lower leg in relation to the thigh.
An ACL tear may occur in an athletic or non athletic setting in which the knee is forcefully hyper-extended and/or internally rotated.
Other causes include:
- medially directed trauma to the outside of the knee
- continual trauma and wear and tear (at any age)
- quick directional changes (most commonly during athletic events)
Statistics from the National Collegiate Athletic Association (NCAA) show that females injure their ACL more than males, and other studies show that ACL injuries occur mostly in individuals aged fourteen to twenty-nine years.
During ACL reconstructive surgery, orthopedic surgeons replace the sprained ligament with a graft from the patient’s body, commonly using a tendon of the kneecap or hamstring. If surgery and four to six months of rehabilitation therapy are done correctly, the patient will be able to return to normal levels of activity with reduced pain while having good knee function and stability.
The most common reason for a failed surgery is positioning the graft ligament in a non anatomical way that does not allow it to restore rotation to the knee.
Other common reasons for an ACL repair to fail are:
- inadequate recovery time
- the physiology of the patient (how their bones and muscles align)
- coinciding knee injuries (ligament or cartilage)
- re-injuring the area with intense physical activity
- incorrect surgical techniques
As with any surgery, talk to your doctor about the risks and complications of the procedure and make an informed decision.