Acl Reconstruction

ACL Reconstruction

The anterior cruciate ligament, abbreviated as ACL, is one of the vital ligaments that constitute the knee joint. These ligaments serve a crucial role in maintaining stability within the knee by connecting the femur (thigh bone) and the tibia (shin bone).

The ACL plays a pivotal role in ensuring knee stability during various physical activities. ACL injuries are widespread, affecting athletes of all ages and competitive levels. Sports such as football, hockey, judo, wrestling, and basketball, which involve rapid movements and pivoting, are particularly prone to ACL injuries. It's worth noting that the incidence of ACL tears is higher in female athletes compared to their male counterparts.

Normal ACL (Intact ACL)

Large Tibial Tunnel on CT Scan for Failed ACLR

A healthy ACL is like a structural pillar that provides stability to the knee joint treatment. It extends from the back of the femur, near the knee cartilage surgery, to the tibia, aligning with the anterior root attachment of the lateral meniscus. When the ACL is intact, the knee functions smoothly, allowing for a wide range of movements without any hindrance.

ACL Tear (Mid-Substance Tear)

Large Tibial Tunnel on CT Scan for Failed ACLR

However, when an ACL tear occurs, there is a disruption of the ligament's fibers. This loss of continuity signifies a torn ACL. Such injuries can happen during sudden, non-contact movements or as a result of trauma. When the ACL is torn, it compromises the knee's stability, leading to pain, swelling, and limitations in mobility.

It's essential to recognize the significance of the ACL in maintaining knee function and stability. In case of injury, seeking prompt medical attention and appropriate ACL injury treatment, such as ACL reconstruction, can help individuals regain their mobility and quality of life. Don't let an ACL injury hold you back; take action and get back to doing what you love.

Large Tibial Tunnel on CT Scan for Failed ACLR

Symptoms of an ACL Injury

Patients who experience an ACL (anterior cruciate ligament) injury often describe specific symptoms that signal a problem with the knee joint treatment. Recognizing these symptoms is crucial for early diagnosis and treatment

  • Knee Instability : One of the hallmark symptoms of an ACL tear is a persistent feeling of instability in the knee. Patients frequently report that their knee feels unsteady as if it might "give out" or suddenly pop out of place, especially during weight-bearing activities or sudden movements.
  • Pain and Swelling : ACL injuries often come with pain and swelling around the knee joint. This discomfort can range from mild to severe, depending on the extent of the injury and any associated damage.
  • Limited Range of Motion : Individuals with an ACL injury may experience difficulty in fully extending or flexing their knee. This limited range of motion can hinder daily activities and sports participation.
  • Audible "Pop" or Snapping Sensation : Some patients recall hearing an audible "pop" at the time of the injury, accompanied by a snapping sensation in the knee. This sensation can be alarming and is often followed by immediate pain and swelling.
  • Difficulty Walking : Walking or bearing weight on the affected knee can be challenging for those with an ACL injury, particularly during the acute phase of the injury.

  • Given these symptoms, it's no surprise that many individuals with ACL tears opt for ACL surgery to address the injury. This is often motivated by the desire to resume sports or activities that involve contact or rapid twisting movements.

    It's important to note that ACL injuries frequently occur in combination with other injuries, affecting structures like the meniscus, articular cartilage, or knee ligament surgery in approximately 50 percent of cases. Such additional injuries can exacerbate symptoms and complicate the recovery process.

    Dr. Amit thoroughly evaluates each patient's knee, employing clinical tests, X-rays, and MRI scans to confirm the ACL injury and assess any associated damage to other knee structures. Early and accurate diagnosis followed by appropriate treatment, such as ACL reconstruction, and ACL injury treatment, can help patients regain stability, reduce pain, and prevent further complications, allowing them to return to their active lifestyles without any hindrance.

    Treatment for an ACL Tear

    When it comes to addressing an ACL (anterior cruciate ligament) tear, timely and appropriate treatment is essential to minimize long-term complications and ensure a return to an active lifestyle. The choice of treatment depends on the severity of the ACL injury and any associated damage.

  • Grade I ACL Tear (Mild) : In cases of a Grade I ACL tear, where the ligament is stretched but not torn, conservative treatment such as physical therapy and rehabilitation may be sufficient. This approach focuses on strengthening the surrounding muscles and stabilizing the knee joint, allowing the patient to regain stability and functionality.
  • Grade II ACL Tear (Moderate) and Grade III ACL Tear (Severe) : For patients with more severe ACL tears (Grade II or Grade III), and especially those who also have a meniscus tear, the risk of developing osteoarthritis in the future is significantly higher. To mitigate this risk and ensure optimal recovery, Dr. Amit typically recommends a combined approach that includes both meniscus repair and ACL reconstruction.
  • Meniscus Repair : Repairing the damaged meniscus is crucial, as it plays a vital role in knee stability and function. Meniscus repair involves suturing or reattaching the torn meniscal tissue, allowing it to heal and function effectively.
  • ACL Reconstruction : ACL reconstruction is a surgical procedure that replaces the torn ACL with a graft, typically sourced from the patient's own tissue or a donor. This reconstructive surgery helps restore knee stability and function, reducing the risk of osteoarthritis and enabling patients to return to their active lifestyles with confidence.
  • Young or Active Patients : Dr. Amit strongly recommends ACL reconstruction surgery for young individuals and those who remain physically active. This proactive approach not only facilitates a swift recovery but also helps prevent future knee instability and complications, especially during twisting or turning activities.

  • By addressing both the ACL tear and any associated meniscus damage comprehensively, patients can achieve better outcomes and reduce the likelihood of long-term knee issues. Dr. Amit's expertise and tailored treatment plans ensure that individuals receive the most appropriate and effective care for their ACL injuries, enabling them to enjoy an active life without any play limitations.

    Description of ACL Reconstruction

    ACL (Anterior Cruciate Ligament) reconstruction is a meticulous surgical procedure that demands a deep understanding of knee anatomy, the precise location of ACL attachment sites, and comprehensive knowledge of the knee's ligaments and structures. The success of ACL reconstruction hinges on accurate graft placement and addressing any concurrent injuries to ensure optimal outcomes.

  • Precise Graft Placement : The cornerstone of a successful ACL reconstruction lies in the precise placement of the graft. On the tibia (shinbone), the tunnels for graft placement should align with the posterior margin of the anterior horn of the lateral meniscus. On the femur (thigh bone), the reconstruction tunnel should be strategically positioned at the midpoint of the attachment bundles of the anteromedial and posterolateral bundles. Importantly, the primary portion of the reconstruction tunnel should be posterior to the lateral intercondylar ridge, known as the "resident's ridge."
  • Avoiding Common Pitfalls : A critical technical aspect of ACL reconstruction is preventing common pitfalls that can lead to graft failure or compromised knee stability. These include:
  • Tibial Graft Placement : Placing the graft too posterior (central) on the tibia can result in an inability to control knee rotation, increasing the risk of graft stretching or failure.
  • Femoral Graft Placement : Grafts that are positioned too anterior on the femur (anterior to the resident's ridge) or too central may only effectively reconstruct the anteromedial bundle, leaving the knee vulnerable to rotational laxity.
  • Minimizing Graft Failures : A significant number of ACL reconstruction graft failures occur when these critical positioning guidelines are not followed. A properly executed ACL reconstruction ensures that the graft is securely placed in a way that replicates the natural function of the ACL, enabling the knee to regain stability and functionality.

  • In summary, ACL reconstruction is a highly technical procedure that requires precision and expertise. By adhering to the correct graft placement guidelines and addressing any associated injuries, patients can maximize the chances of a successful recovery, ensuring that their knee functions optimally and without any play or instability. Trust in the expertise of Dr. Amit for meticulous ACL reconstruction surgery, giving you the best chance at a full and active life.


    The journey to a full recovery after ACL (Anterior Cruciate Ligament) reconstruction surgery doesn't end in the operating room—it's just the beginning. Comprehensive post-operative care plays a pivotal role in achieving the best possible outcomes. At our practice, we emphasize the importance of a well-supervised physical therapy protocol tailored to each patient's unique needs.

    Key Elements of Post-Op Care

  • Quadriceps Reactivation : Reactivating the quadriceps muscle group is a top priority. Strengthening these muscles is essential for knee stability and function, helping you regain strength and mobility.
  • Edema Control : Managing post-operative swelling (edema) is crucial. Our physical therapy protocols include techniques to reduce swelling, ensuring a smoother recovery process.
  • Patella Mobilization : Ensuring the proper movement of the patella (kneecap) is vital for optimal knee function. Our physical therapists employ techniques to promote patellar mobility.
  • Maintenance of Full Knee Extension : Maintaining full knee extension is a critical goal. It prevents the development of contractures and ensures that your knee can fully straighten.
  • Regaining Knee Motion : Restoring knee motion is a gradual process. Our tailored physical therapy plans are designed to help you regain a full range of motion at a pace that is safe and comfortable for you.
  • Dedicated Rehabilitation : In our practice, we prioritize your post-operative care by strongly recommending that patients remain in the vicinity for a minimum of 5-7 days after surgery. This allows us to provide you with continuous, hands-on care and ensures that your rehabilitation progresses to advanced levels more swiftly. Our experienced physical therapists work closely with you, monitoring your progress and making necessary adjustments to your therapy plan.
  • Optimal Outcomes : By following a comprehensive post-operative care plan, you enhance your chances of a successful recovery. Our goal is to help you regain full function, stability, and confidence in your knee. Your commitment to post-operative care, coupled with our expertise, will pave the way for a brighter, more active future without any setbacks.

  • Trust in our team to guide you through every step of your post-operative journey, ensuring that you achieve the best possible results and enjoy a life free of limitations.


    When it comes to your ACL (Anterior Cruciate Ligament) reconstruction, choosing the right healthcare provider is paramount for a successful outcome. At KNEECARES, we offer a range of compelling reasons why we should be your top choice for this critical procedure

  • Expertise in Complex Cases : For patients with complex cases involving multiple ruptured ligaments, our team is well-equipped to handle even the most challenging scenarios. We have the expertise and experience to assess, diagnose, and recommend the most suitable treatment plan.
  • Allografts from Certified Tissue Banks : In cases where an allograft (or tissue transplant) is necessary, we prioritize your safety and well-being. We exclusively utilize grafts sourced from tissue banks that have undergone rigorous FDA inspections and are certified by the American Association of Tissue Banks (AATB). This commitment ensures that you receive the highest quality tissue grafts, minimizing the risk of complications.
  • Personalized Treatment : At KNEECARES, we understand that each patient is unique. Your ACL reconstruction treatment plan will be meticulously tailored to your specific needs, ensuring the best possible outcome. We take into account your age, activity level, and the extent of your injury to provide personalized care.
  • Comprehensive Rehabilitation : Our care extends beyond surgery. We offer comprehensive post-operative ACL rehabilitation programs aimed at facilitating a smooth recovery. Our physical therapists work closely with you to restore strength, mobility, and function in your knee.
  • Cutting-Edge Techniques : We stay at the forefront of medical advancements in ACL reconstruction. Our best ACL surgeons are proficient in utilizing the latest techniques and technologies to optimize surgical outcomes and minimize recovery times.
  • Patient-Centered Approach : Your comfort and well-being are our top priorities. We take the time to explain your treatment options, address your concerns, and involve you in decision-making throughout your journey to recovery.
  • Proven Track Record : Our clinic has a proven track record of successful ACL reconstructions and positive patient outcomes. We take pride in our reputation for excellence in orthopedic care.

  • Choosing KNEECARES for your Best ACL reconstruction means entrusting your knee health to a team of experts dedicated to your well-being. With our commitment to safety, personalized care, and advanced techniques, we're here to guide you every step of the way on your path to recovery. Don't settle for anything less than the best when it comes to your ACL reconstruction; choose KNEECARES for exceptional care without any compromises.

    While ACL reconstruction may appear to be a common operation, the procedure requires highly trained and experienced surgeons to ensure that the proper graft is placed in the anatomically correct position in the knee.
    Our rigorous follow-up studies of patients who have ACL reconstructions have provided some very important information to the community.