Ligament Reconstructions...


Anterior Cruciate Ligament reconstructions or Posterior Cruciate Ligament reconstructions are both specialties of Dr. Jansson.


Most Ligament reconstructions will be done by using a graft to replace the ligament, and there is a long discussion that we have with you on the pro's and con's of graft choices.  A graft comes either from your own body, or from a donor source.

Options will include:

•  B-T-B autograft, which is the patellar tendon graft harvested from the front of your knee and will include the attachment to the bone at the patella and the attachment to the bone on the tibia.

• Other Autografts could be a hamstring tendon or quadriceps tendon

• Allograft, which will consist of the Achilles tendon taken from a donor, or cadaver.  These grafts go through a special harvesting by a bone bank which tests the graft for any potential diseases or contamination. Once testing is completed and negative, the graft is released for public use. 
  
  
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Normal ACL Ligament:


Torn ACL Ligament:




The ACL will be debrided out, exposing the normal PCL and preparing the notch for the new ACL graft to go across.


A guide pin will be drilled across the joint in locations to allow the best placement for the ACL graft.   


A tibial tunnel will be drilled followed by a femoral tunnel:

• this is the femoral tunnel
  
  
  Then, a graft will be pulled across the joint and then secured in the tunnel with a screw:  Completed!

• A screw and washer are used to hold the graft to the Tibia on the other side of the tunnel.
   

• An X-ray of the knee after the surgery looks like this:
  
  
  After your graft has healed, it should look like this:

          This is a picture of a graft about 8 months after surgery.

Very rarely can the actual ligament be repaired, but sometimes if the ligament has been pulled off the base with a section of bone and then that piece may be repaired in a special procedure.

                


We protect you in a brace for about 3 months while your up and around, and after 3 months only when you are on uneven surfaces or jogging.  The brace should be worn for sports after you have been released for about a year.

 

Posterior Cruciate Ligament Reconstructions...


The PCL can be reconstructed in the same manner as the ACL, with small holes and a small incision, but the graft is an allograft due the the length needed for a graft.  These surgeries are more rare than an ACL reconstruction.



We protect you in a brace for about 3 months while your up and around, and after 3 months only when you are on uneven surfaces or jogging.  The brace should be worn for sports after you have been released for about a year.

Physical Therapy is an integral part of your recovery.  Most patients miss maybe a week or less of school or work...