Arthroscopic surgery for a damaged knee ligament.
An ACL reconstruction is the most common surgical procedure for the repair of an injured ACL and it typically provides the best results and the fastest recovery. .
This surgical procedure removes the damaged ACL and replaces it with a graft. .
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The graft often consists of a section of the patient's own patellar tendon (a large, strong tendon of the quadriceps muscles). If this graft is selected, a small section of bone is also taken with the graft. This allows bone-to-bone healing, which is generally faster and stronger than a soft tissue graft. .
Another common graft comes from the semitendinosus tendon which is one of the smaller hamstring tendons. This graft typically results in less pain but longer healing times due to the soft tissue to bone graft. .
A new graft technique uses a portion of the quadriceps tendon,and has bone at one end and soft tissue at the other. This procedure generally has a strong connection but less overall pain. .
In some cases the graft will come from a donor, rather than the patient. If there isn't enough graft tissue available or if the patient is older, donor tissue may be used. .
ACL reconstructions are almost always done with one or two arthroscopic incisions, although some injuries may require open surgery. An arthroscope is inserted into the small opening and a camera at the end of the scope projects pictures of the joint on a TV monitor. Small drills are inserted through other incisions and small holes are drilled into the upper and lower leg bones (through which the graft will be anchored). If the graft is coming from the patient, the surgeon will take the tissue at this time.