ACL is a thick of fibro collagenous tissue connecting the lower end of thigh bone and upper end of leg bone. It is one of the important ligament inside our knee joint which gives stability.It is the most common ligament injury in sports or RTA in our region.
It is the most common ligament injury in the knee. Any contact sports involving twisting of the knee joint can cause ACL tear. Eg. Foot ball, volley ball, rugby etc.
Acute injury is treated is conservatively with Brace and analgesics. After 3-6 weeks of review if there is instability , then they need to undergo ACL reconstruction.
ACL is reconstructed with a graft which is a PTB (Patellar tendon bone) or Hamstrings ( semitendinosis or gracilis) muscle This graft is fixed by various methods like titanium screws, bio absorbable screws, endo button, tight rope.
We do an “all inside ACL reconstruction with graft link tightrope technique”. The advantages of this technique is that it is very strong, single semi tendinosus graft is enough, NO screw or threads prominence over the tibial insertion site. Leg bone outer side is not tunnelled, so less painful and hence early recovery. Only very few surgeons are doing this all inside technique.
Posterior Cruciate ligament(PCL) is another ligament inside the knee joint which is more stronger than the ACL ligament and is less often torn. It is a very important structure for knee stability. It has to be reconstructed if it is torn completely
A completely torn PCL is reconstructed with hamstring graft done arthroscopically . PCL is reconstructed in a similar fashion to ACL with special instruments but needs a lengthier graft.
Meniscus is a thick fibro cartilaginous tissue inside the knee joint. There are two menisci in the knee joint. They function as shock absorbers and getting a smooth knee movements in the knee joint.
Meniscal tear is the most common injury to the knee. A tear in meniscus presents as pain in the knee joint on weight bearing, locking of the knee joint while walking, or simply pain with swelling.
Meniscus is a semi-circular structure with broad outer edge and thin inner edge. Tears towards the outer edge have good blood supply and heal well with repair and tears towards the inner edge and irregular tears are not repairable and so they undergo partial menisectomy i.e torn part of the meniscus is removed and the remaining part is trimmed smoothly to prevent further tear.
There are various kinds of techniques available and is dependent on the area of tear over the meniscus. Repair technique is based on tear pattern.
Arthritis can occur after 10-15 years if the meniscus is removed completely but nowadays meniscus preserved to the maximum with the latest techniques of repair or partial menisectomy to prevent secondary arthritis.