Anterior cruciate ligament reconstruction using a double-stranded hamstring graft
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An ACL reconstruction is indicated to eliminate the pivot shift experienced as the knee dislocates during direction change, be it day to day or during sport. The operation is not intended, or indeed able, to eliminate pain, swelling or stiffness. This must be made clear to the patient for appropriate counselling.
Timing of the reconstruction is also important. A painful, stiff knee is often best suited to a pre-operative period of high quality physiotherapy as there is a risk of persistent pain and stiffness even after a “successful” ACL reconstruction. There is evidence to show that there is an increased risk of arthrofibrosis if surgery is performed between 2-6 weeks post injury.
The technique described is an arthroscopic anterior cruciate ligament reconstruction using ipsilateral hamstrings (double-stranded semitendinosus and gracilis).
Author:Mr Andrew Pearse FRCS (Tr & Orth)
Institution: The Worcestershire Acute Hospitals NHS Trust, UK.