From an interview with
Dr. Jeremy McCallum
McLeod Orthopaedics  Seacoast

Your ACL – also known as the anterior cruciate ligament – is one of the strong bands of tissue that help connect your thigh bone to your shinbone. An injury can cause this ligament to pop and shred.  McLeod Orthopedic Specialist Dr. Jeremy McCallum explains what can cause an ACL tear and how it can be repaired.

Here’s a summary of Dr. McCallum’s comments:

An ACL tear is one of the most common type of sports injuries. Classically, the damage happens when an athlete plants their foot and pivots on it.  Generally, it does not occur with contact. The athlete will feel a big pop in the knee, and it becomes very swollen. They will not be able to walk on it. Once an athlete has an ACL injury during play, it’s very rare to be able to continue athletic activity.

When an ACL tears, it obliterates the ligament. There are a few cases, in which most of the ligament remains intact; when that occurs, repairs, rather than replacement, can be considered. In 90% of ACL tears, a minimally invasive procedure can be performed. First, we take a camera and put it into the knee to look at the entire joint. We assess the cartilage of the meniscus and the joint. We look at the other ligaments. We drill tunnels into the femur and tibia bones of the leg. Then, we pass a graft through these tunnels. The graft material can be taken from a cadaver tendon or it could come from the patient’s hamstrings, quadriceps or patella. The different grafts all perform similarly, although there may be specific preferences, depending on who is doing your surgery. These grafts are then fixed with either screws or buttons to tension the graft appropriately. After surgery, the body will actually absorb some of that graft and then use it as a scaffold to regrow a new ACL.

The recovery after an ACL reconstruction is probably the most difficult part of the whole process. After a week or two, most athletes and patients are walking on the leg with no pain and near full range of motion. Occasionally, if a meniscus repair has to be done, there will be more limitations on bending and weight-bearing for four to six weeks. By two months after surgery, nearly everyone is feeling like they should be allowed to run. However, the issue is that the ACL is not strong enough, and a simple misstep can cause a re-tear of the ACL.

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