You will recall that the anterior cruciate ligament is one of two very important ligaments within the joint that provide stability both forwards and backwards, and when the joint is being rotated.
Some patients can cope with the loss of an anterior cruciate ligament and perform quite satisfactorily with most activities of daily living.
Others are not so fortunate. They require a so-called “cruciate ligament reconstruction”.
Once the ligament is ruptured, simply suturing it together is of no great use. The environment within the knee joint prevents the ligament healing. It is therefore necessary to use some form of supplement to reconstruct the ruptured cruciate ligament.
The supplement is usually in the form of tendons taken from the patient’s own thigh. These are the so-called “hamstring tendons” of semitendinosus and gracilis. They can be harvested through a small incision just below the knee joint, can then be bound together and then passed up through a tunnel in the upper end of the shin bone, out through a tunnel in the lower end of the thigh bone to reconstruct the cruciate ligament that has been ruptured.
The operation itself is not particularly difficult although it does require special technical expertise.
The post-operative recovery is very important. Many Orthopaedic Surgeons ask their patients to wear a limited range of motion brace for three weeks or so. Thereafter, intensive physiotherapy is required with a gradual reintroduction of usual social, recreational, domestic and remunerative activities. Rigorous bipedal sporting pursuits are usually delayed for up to twelve months.