If the ACL is torn, it will not heal without surgery. For patients who are less active and do not participate in activities that include running and jumping, they may work with their physician to create a stability plan. This will likely include nonsurgical treatments such as physical therapy and bracing.
For those who need surgery, the ACL ligament will be replaced entirely. The ligament is replaced with a tendon, which then acts as a graft. The graft will mature over time and become a new, living ligament.
The surgery is performed by having small incisions made over the front of the knee cap. The ligaments needed for the graft are then removed. The incision is closed and the remainder of the surgery is performed through small incisions on the side of the knee. From there, a fiber-optic viewing scope is used to assist the surgeon and guide the ACL graft into place.
While the knee is bent, the damaged ACL is cleared away. A pin is then inserted and will act as a guide to recreate the ACL. Holes are then drilled into the tibia and femur. The graft is attached to the guide pin and it’s pulled through the drill holes into place. Once complete, special screws or other fixation devices are used to secure the ends of the graft to the femur and tibia. The knee is then flexed to test the new joint.