Anterior cruciate ligament reconstruction Middle-third bone/patella tendon/bone autograft

Description: Anterior cruciate ligament (ACL) rupture is a common, and initially often overlooked injury of the knee. Whether the true incidence of the injury is on the increase, or simply its professional recognition, is hard to say, but reconstruction for functional instability has developed rapidly over the last two decades. Not all ACL-deficient knees need stabilising, and unfortunately not all stabilised knees return to full function, so careful patient selection is very important in this group of patients. Once selected, adequate time must be spent in preoperative counselling to discuss the issues of the time implications, the critical importance of post-operative physiotherapy and rehabilitation, the risks of success and failure, as well as the complications, potential graft site morbidity and the alternative conservative approaches. These latter include proprioceptive physiotherapy and/or bracing for specific sporting activities. In support of this we provide a patient leaflet which includes details of the knee’s anatomy, surgical techniques, rehabilitation protocols, as well as expected outcomes and references.
C.M. Fergusson Department of Orthopaedic Surgery, Royal Berkshire and Battle Hospitals NHS Trust, Reading, U.K. J.R.Coll.Surg.Edinb., 45, February 2000, 33-43