ACL reconstruction technique is a combination of arthroscopy and open surgery. Through an arthroscope, the surgeon checks the knee and repairs conditions such as rubbed down articular cartilage or torn meniscus.
Small holes will be drilled in the bone via an incision in the hip. The new ACL is added to be guarded via the tunnels. With the healing process, the tendon is strengthened through the passages of the body. Through the arthroscope, the inflow cannula responsible for bringing blood into the joint is visualized. The trochlear groove is located in the arthroscopic view at the left, and the patella is found at the top. For inspection of the meniscal cartilage, a probe is inserted.
With a motorized device called shaver, the damaged ACL is removed. In some patients, the notch that houses the ACL can be quite narrow. This has to be widened in that case to prevent the rupture of the new ACL with the help of a burr.
Now the patella tendon has to be focussed on. At the tibial tubercle and at the inferior pole of the patella some incisions are made. These incisions are 1.5 inches each in length.
The tendon is identified after the skin incisions are made and harvesting of the central third with a bone block at each of the tendons is then done. From the tibial tubercle are the tendon is removed and a graft is made to pass under the skin and retrieved through the superior incision. In this way, the harvesting is completed.
Via the bone blocks, the sutures are placed on the graft. Now focus is on the arthroscopic part. On the tibia, the tibial drill guide is positioned. The guidewire is penetrated into the tibia and leaving the region through the joint. The drill hole of the tibia is then positioned.
Through the tibial drill hole, the endoscopic femoral drill guide is placed. Behind the femur, the guide is positioned. The femoral drill makes a hole in the femur after the femoral guide is withdrawn. The hole has to be inspected and the graft is then placed via the tibia, and inside the femoral drill hole via the knee joint.
It is important that blood vessels start growing into the reconstructed ACL for the graft to heal. The graft is made to stay in place with the help of a screw inserted into the femoral drill hole. This screw is a special screw since it is bioabsorbable. Another screw is placed in the tibia to keep that particular reconstruction part in place.
The ACL is now inspected which is actually a rigid rope-like structure meant to provide strength and stability to the joint. The procedure is completed by closing the incisions.