What is the difference between ACL reconstruction and ACL repair?

The terms ACL reconstruction and ACL repair sound similar, but the surgical procedure is different. Both are used to treat an ACL Tear, but they are unique in how and when they should be used. Many patients find an “all or nothing” mentality with their orthopedic surgeon where some surgeons will only repair an ACL tear and other surgeons prefer to only do an ACL reconstruction. The specialists at BICMD are experts in treating ACL Tears and will perform the necessary surgery for an ACL tear, whether that procedure is an ACL reconstruction or ACL repair. Through our telemedicine portal, you can be evaluated, and our world-class orthopedic surgeons can give you the best advice for your specific ACL tear.  In general:

  • ACL Repair – When the Anterior Cruciate Ligament is repaired and not replaced. In the past, an ACL repair was only performed when the injury caused a piece of the bone and the ligament to separate from the remaining bone. The goal of this type of repair is to reattach the bone fragment to the bone. However, newer techniques and research have prompted a resurgence of ACL repair for very specific types of ACL injury, with or without a bone fracture. ACL repair is appropriate in lower-energy injuries and in some soft-tissue injuries where the ACL is pulled from the bone but is still intact structurally.
  • ACL Reconstruction – The most popular and preferred treatment for an ACL Tear, replaces the torn ligament completely. ACL reconstruction is used when the ligament cannot be salvaged. ACL reconstruction for an ACL Tear is appropriate for active individuals who experience persistent knee pain and knee instability following an injury. Athletes who want to return to their active lifestyle are good candidates for an ACL reconstruction.

What is a torn ACL?

Tearing your ACL is not uncommon. In fact, a torn ACL, or anterior cruciate ligament occurs more often than any other knee injury in sports. The ACL is a ligament in the knee that connects the femur (thigh bone) to the tibia (or shin bone) and is located in the center of the knee. The ACL can be torn in sports that cause a sudden shift or change in direction. Sports that have the most ACL injuries include basketball, football, soccer, skiing and tennis.

What is the difference between an autograft and an allograft?

A graft is a portion of tissue used to repair a torn anterior cruciate ligament. There are two types of grafts, an autograft and an allograft.

ACL Autograft:

An autograft is a piece of tissue, obtained from the patient’s own body. An ACL autograft has the following advantages:

  • Autografts are the preferred type of graft and the best choice for ACL reconstruction.
  • Less costly to obtain than allografts.
  • Quicker healing time
  • Less chance of infection

ACL Allograft:

An allograft is a piece of tissue used for the ALC repair that is obtained from a donor, or cadaver. Allografts are used when the patient does not have viable tissue that is available or can be used for the graft. This can occur in athletes who have had multiple ACL or other tendon tears and reconstructions. Older individuals who are more sedentary should allow for additional healing time.

What is the best type of graft for an ACL reconstruction?

The type of autograft used for an ACL reconstruction depends greatly on what is available from the patient and the goals of recovery. The most often used autografts for ACL reconstruction are:

  • Patellar tendon autograft (preferred autograft)
  • Hamstring autograft
  • Quadriceps tendon autograft

What happens during an ACL Reconstruction?

An ACL reconstruction is done by replacing the torn ACL with an autograft that is secured at the original attachment sites of the native ACL. During this specialized surgery, the doctor removes the torn or fragmented ACL as well as any other areas of soft tissue that are damaged. The surgeon then creates small tunnels through the bones of the femur and the tibia. The new ACL graft is threaded through the tunnels and secured with either screws or a surgical loop and button which is placed on the outside of the bone tunnels. The overall goal of ACL reconstruction is to replace the torn ligament and reestablish the stabilizing properties of the original ACL. The experts at BICMD can explain to you the nuances and details associated with ACL surgery.

What happens after ACL repair or reconstruction?

The rehabilitation protocol is similar in both an ACL repair and an ACL reconstruction. Patients treated for this condition can expect the following:

  • Most ACL repairs and reconstructions can be done on an outpatient basis and patients can go home the same day.
  • Pain medication should be taken as recommended.
  • Ice, elevation and rest will be needed in the hours following surgery.
  • Patients are given a rehabilitation protocol that is tailored to their specific type of ALC Surgery.
  • Physical therapy is started immediately in order to reestablish range of motion.
  • Strengthening exercises will begin when recommended.
  • Return to fitness activities can resume in about 6 to 12 weeks.
  • Full return to sport usually occurs in about 8 to 9 months.

For more information on ACL repair and ACL reconstruction, or to be evaluated for your torn ACL, please click on “Connect With a Doctor” to reach one of our orthopedic telemedicine experts. Our physicians are the top orthopedic doctors in the country and are extremely skilled at diagnosing your knee injury.