Causes and Symptoms :
ACL injuries occur during sports and activities involving the knee to extend beyond capacity thereby causing excessive strain to the ligaments. Sports (football, basketball, acrobatics) that involve hasty movements or change of direction or getting directly hit on the knee by external forces- are major causes of it. Other causes can occur from:
- Landing with an abrupt slow pace or position.
- Sudden halt or fall.
- Elderly people with weak muscular ability may face this injury during their regular activities.
- The injury can also lead to knee osteoarthritis.
Certain symptoms of an ACL injury of the knee usually include:
- A popping feel in the knee followed by a lump in the affected area.
- Excessive pain with restrained knee movement.
- Difficulty in performance of regular normal tasks.
Methods of ACL Reconstructive Surgery:
The outcome of the surgery (arthroscopic in nature) is generally positive. The selective method of ACL graft tissue is made by the surgeon .Each technique has its own characteristics applied for getting similar results. The two commonly used grafting methods are the Autografts (patellar tendon and the hamstrings tendon) and the Allograft.
The Hamstring Tendon Graft is most common as it delivers excellent success with a 90-95% rate in terms of restoring proper functioning of the knee. It is often coupled with the semitendinosus or the gracilis tendon for making the graft more strong. The tendon segments are then folded and intertwined to form a thicker strand and it replaces the damaged ligament at the affected juncture.
This autograft technique is fast and easier strengthened by bones on each end of the graft which forms a hollow passage preventing any damage. It inflicts a smaller wound as the incision is small and thus less painful , thus avoiding the risk of any nerve injury.
Despite the fixation techniques being good, hamstring tendon grafts still depend on soft tissue-to-bone recovery procedure. A process known as the ‘tunnel widening’ may surface after the replacement where the endings of the bone in the femur tend to expand out. This process also requires considerable surgical experience and athletic participation is naturally slower taking from 1 to over 2 years or more.
Patellar Tendon Graft or patellar tendon bone-tendon-bone (BTB) graft is another autograft method forming a conjugation between the patella (kneecap) and the tibia (shin). The injured knee itself provides for the graft material which is fused through holes and inserted into the injured area. The outcome is effective over 5-6 months period.
However, the graft faces the risk of ruptures which might appear during the early week of surgery in case the injured area is exerted to pressure. The incision for this surgery is bigger and is allied with more pain kneeling tenderness.
Quadriceps Tendon Graft: This technique employs autograft methods comprising of a tendon graft with bone on one end and soft tissue on the other. Faster recovery is assured as the incision made for the reconstruction is small thereby lessening affliction. The graft being a donor’s own tissue significantly causes bone graft harvesting morbidity to be minimal.
If there arises a difficulty in the procurement of the patient’s own tissue, the allograft method is recommended. However, it might lead to the contraction of serious infective diseases with fatal outcomes like Hepatitis and HIV and also cause bacterial infections. Thus, the allograft needs to be completely processed and sterilized before transplantation into the patient’s damaged area which can again weaken the strength of the tissue. Cost and availability are also of major concern in allograft reconstruction.
Synthetic (Prosthetic) grafts like carbon fibers, polyster and others are slowly entering the reconstruction scenario where an artificial ACL performs the similar functions as a normal ACL in terms of strength, flexibility, and lasting without any adverse effects. The process of healing under this surgical method is also speedy.
Unfortunately, no synthetic ligaments have met the requirements for a lasting ACL substitute yet and research on this is still in continuance. Recently, mesenchymal cells are being employed in stem cell transplantation enabling athletes to recover faster after the ACL surgery.
Which Graft is Better – Autograft or Allograft?
Both grafts provide excellent results, functionally & clinically. However both choices have their added disadvantages. Autografts though serve to be more firm doesn’t possess a significant difference from Allograft. The rehabilitation period in case of Autograft surgery is longer and patients may undergo immoderate pain.
On the contrary, usage of allograft, the tissue of which comes from human donor enhances the process of repairing and makes recovery quick. However, a major concern regarding allograft is the contraction of fatal infective diseases, which does not, pertain to the usage of autograft. The recovery process for any ACL surgery invariably incorporates knee and other stretching exercises followed by varied sport activities for athletes.
Why choose Travcure in ACL Graft reconstruction in India?
Travcure India medical packages are well connected with premium global healthcare networks & provide cost effective and are designed to suit the patients need, irrespective of one’s financial concerns. It delivers affordable and enhanced degree of different joint replacement surgeries in India which are executed by highly experienced orthopaedic surgeons ensuring sure success.