This “crucial” ligament is vital in maintaining the stability of the knee, particular in high impact sporting activity eg running and contact sports, netball, basketball, tennis etc
If this ligament is non-functional, the patient, whether an sportsperson or not, runs the risk of falling with no warning in their day-to-day activities. This can be dangerous of itself; but can also cause further damage inside the knee.
All patients are assessed individually based on their symptoms, but in general most active patients who have instability could be candidates for reconstruction.
All surgical candidates will have a MRI first, to determine if there are any other internal knee injuries, such as a meniscal tear. If this is present, it also should be repaired if possible, and as the rehabilitation is completely different, it is done first, with the ACL reconstruction usually performed 6-8 weeks later.
In the majority of patients, Dr Shooter would use the patient’s own hamstring tendons to create the reconstructed ligament. This is a well-accepted technique with excellent long-term results reported. The other technique is to use part of the patellar tendon; Dr Shooter prefers to avoid this technique due to concerns with post-operative chronic anterior knee pain.
In recurrent/revision situations, or the high-demand athlete who wants an earlier return to sport, Dr Shooter has experience (and good results) with use of the LARS ligament (Corin), an artificial supplement to the hamstring graft. The downside is this construct may not be as durable as an all-hamstring graft, and may fail within five years, occasionally earlier, in the high-demand athlete. The other situation where an augmented reconstruction is useful is in the patient, usually female, who has ligamentous laxity.