After evaluating the MRI results, the orthopedic surgeon recommended surgery to reconstruct the ACL.  Derrick was a young athlete who had dreams of playing professionally, and would need the full function of his knee.  Derrick would definitely not return to play this season, but if all went well, would return the following season.

Instructor's Note:  A conservative, non-surgical approach of treating an ACL tear is also an option.  The patient undergoes extensive physical therapy to strengthen the knee.  Although the knee will not function as well as it once did, this is often the best approach for an older or nonathletic patient.

The surgery would not take place for 3-6 weeks.  The swelling in the knee would need to subside as well as the hemarthrosis for the surgery to be successful.  The presurgery goal would be to reduce swelling and pain and restore a full range of motion.  Derrick would begin physical therapy as soon as possible.  The goals of the first phase of physical therapy were to minimize swelling, pain, and hemorrhage after surgery; establish and maintain full knee extension; achieve good quadriceps control; and to begin working on regaining knee flexion and neuromuscular control.*

The orthopedic surgeon preformed surgery one month after the initial injury.  At this point the swelling and hemarthrosis had subsided and Derrick's knee was stronger due to physical therapy.   The surgeon explained that he would perform the surgery arthroscopically.  The surgeon would use a graft from Derrick's patellar tendon to replace the torn ACL ligament.  See ACL reconstruction by arthroscopic surgery.

7.  What is an arthroscope?

8.  What are some advantages of arthroscopic surgery?

9.  Describe the surgical method used to replace a torn ACL.

ACL Reconstruction Surgery

Instructor's Note:  The student may wonder why the torn ACL ligament is replaced, and simply not sutured together.  Surgeons have found that attempting to repair a torn ligament by stitching is ineffective.  The ligaments do not heal or function as they should.  Ligaments are replaced by an autograft (using tendons from the patient's own body), or an allograft (using donated tendons from another body).  A patellar tendon autograft is the most common repair.

* Principles of Athletic Training, Ninth Edition, Arnheim and Prentice, pg. 496.