Knee injuries in sports are a common occurrence. One dreaded injury is a tear of the anterior cruciate ligament (ACL). Most ACL tears occur after a non-contact injury such as a wide receiver or soccer player making a sudden change in direction. The leg planted on the ground during the cutting move may experience enough force to tear the ACL. Seventy percent of acute hemarthosis (blood in the knee) after such injury is an ACL tear.

Non-surgical treatment for complete ACL tears in young, active patients has generally been met with less than satisfactory results. Loss of the ACL can result in instability or the feeling that the knee is loose. The knee wants to “give way” when a change in direction occurs.  This instability can result in further damage to the knee and the C-shaped cartilages called the meniscus. Rebuilding the ACL and restoring stability to the knee can protect the meniscus from further damage.

There are over 400,000 ACL reconstructions a year in the United States. Much research has occurred and is on-going into different techniques and choices of tissue to use to rebuild the damaged ACL. Two of the more common tissue (graft) choices are hamstrings and patellar tendon.  Both are usually taken (harvested) from the same knee and used in the reconstruction process. Other options include quadriceps tendon and tissue that has been donated to tissue banks (allografts). There are pros and cons to each graft choice, but analysis of multiple recent studies show little difference in long term outcomes between hamstring and patellar tendon autograft (tissue taken from the same patient.)

In part two of “ACL Injuries in Sports” we shall discuss current data on the return to sports after ACL reconstruction.

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