You can either manage your ACL injury surgically or non-surgically. Which form of treatment is right for you is determined by you and your health care provider. Surgical treatment
Autograft and Allograft Surgery[ 1]
1. Autograft surgery means taking a tendon or a ligament from another part of your body, also called a graft, and replacing the injured ACL.
2. Allograft surgery is when a piece of ligament or tendon is taken from a cadaver, a deceased body, and used to replace the injured ACL.
In this post we will focus on the autograft surgery. There are two areas where the graft is taken from. The surgeon chooses the graft site for your ACL surgery (also called an ACL reconstruction).
Bone-Patellar Tendon-Bone Reconstruction (BTB)
The patella is the small bone that you can touch in front of your knee and the patellar tendon sits below this bone. The patellar tendon is an extension of the 4 upper thigh muscles called the quadriceps, which allow the knee to straighten. During this surgery, a piece of the patellar tendon is removed and used to replace the ACL[ 5]
Hamstring Tendon Reconstruction (HT)
The hamstrings are a group of three muscles (Semitendinosus, Semimembranosus, and Biceps Femoris) that are located on the back of your thigh. They allow you to bend your knee and bring your hip back. During the Hamstring Tendon Reconstruction surgery, part of the Semitendinosus and Gracilis tendons are used to replace the injured ACL[ 5].
Prior to surgery it is essential to rehabilitate the knee to make sure you are ready for surgery. After surgery you will need at least 6 to 8 months of rehabilitation to return to your prior level of physical activity and sports. This rehabilitation is typically guided by a Physical Therapist but you will have to do at least 60 to 90 minutes of exercises daily. There is a huge time commitment to rehabilitation exercises after ACL reconstruction. Curovate offers a pre and post-operative app which has 6 months of video guided exercises to help you with your ACL recovery.
Progressive Physical Therapy is crucial for the treatment of ACL injuries. Weekly exercises are provided that will reduce knee pain, increase knee mobility, return to normal walking, and eventually return to running and jumping. How much you will be able to do after the injury is based on your particular injury, your knee health before and after the injury and what you and your Physical Therapist decide is appropriate for you. There will be more information on non-surgical management in a future blog post. Stay tuned!
Curovate has a non-operative version of their app which provides video guided exercises and progress tracking to help you recover from your ACL injury.
[ 1]: Bottoni, C. R., Smith, E. L., Shaha, J., Shaha, S. S., Raybin, S. G., Tokish, J. M., & Rowles, D. J. (2015). Autograft versus allograft anterior cruciate ligament reconstruction: A prospective, randomized clinical study with a minimum 10-year follow-up. The American Journal of Sports Medicine, 43(10), 2501-2509.
[ 2]: Chang, S. K. Y., Egami, D. K., Shaieb, M. D., Kan, D. M., & Richardson, A. B. (2003). Anterior cruciate ligament reconstruction: Allograft versus autograft. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 19(5), 453-462.
[ 3]: Engelman, G. H., Carry, P. M., Hitt, K. G., Polousky, J. D., & Vidal, A. F. (2014). Comparison of allograft versus autograft anterior cruciate ligament reconstruction graft survival in an active adolescent cohort. The American Journal of Sports Medicine, 42(10), 2311-2318.
[ 4]: Shelton, W. R., Papendick, L., & Dukes, A. D. (1997). Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 13(4), 446-449.
[ 5]: Wipfler, B., Donner, S., Zechmann, C. M., Springer, J., Siebold, R., & Paessler, H. H. (2011). Anterior cruciate ligament reconstruction using patellar tendon versus hamstring tendon: A prospective comparative study with 9-year follow-up. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 27(5), 653-665.