ACL Repair

Getting back in the game with ACL repair

With Scott A. Sigman, MD, chief of orthopedics at LGH

Pop. That’s what patients often feel or hear when they tear the anterior cruciate ligament (ACL), the major stabilizing ligament of the knee. The ACL is located in the center of the knee joint and runs from the femur (thigh bone) to the tibia (shin bone), right through the center of the knee.

An ACL tear is the most common ligament injury to the knee. It usually occurs during a sudden change in direction, such as when a football, soccer or tennis player quickly slows down and pivots on the planted foot, causing extreme inward rotation at the knee. It can also occur when the foot hits the ground and the knee is straight or hyper-extended, such as when a basketball player comes down after a jump shot or a gymnast lands after a dismount.

“Not all ACL tears require surgery,” explains Scott A. Sigman, MD, chief of orthopedics at Lowell General Hospital and team physician for the U.S. Ski Jump Team and UMass Lowell Athletics. “If someone is middle-aged and just walks for exercise, for example, they probably don’t need surgical reconstruction of their ACL.”

Photo: Kristen Proverb, NP and Scott Sigman, MD

However, in the case of an athlete who wants to return to his or her sport, or if someone has knee instability that interferes with the activities of daily living – such as walking up and down stairs – then reconstruction is often appropriate. The goal of ACL surgery is to restore stability to the knee and the level of function you had before the knee injury, limit loss of function in the knee, and prevent injury or degeneration to other knee structures.

ACL reconstruction is typically done as a minimally invasive procedure using orthopedic techniques to repair the knee through a few small incisions. It’s a fairly common procedure performed at Lowell General Hospital by the orthopedic surgeons who operate at the main hospital and the outpatient surgery center at Lowell General Chelmsford.

Reconstructing the ACL involves removing the torn ligament from the knee and constructing a new one from tendon tissue taken from your own body or a donor. The new ACL is then attached in place to the femur and tibia to rebuild the ligament support of the knee.

While nearly all ACL reconstruction is done as minimally invasive surgery, Dr. Sigman uses a new arthroscopic technique for ACL reconstruction which he has been teaching to orthopedic surgeons around the world.

“Only about ten percent of orthopedic surgeons are currently utilizing this new technique,” he notes, which involves placement of a tunnel through which the new ACL is threaded. “It promises more stability and decreased chance of re-rupture after surgery,” he adds.

Joseph Caveney is a local patient who has benefited from the procedure. The UMass Lowell sophomore is a forward on the school’s Division 1 NCAA hockey team who injured his left ACL during a game in December 2009.

“I tried to play on it for a month but it just wasn’t stable enough,” he recalls. “So I had surgery in February, was back on the ice in June and playing competitive hockey by September. It not only feels fine but now it’s even stronger than my right leg,” he adds.

Your physician can best determine the type of surgery and care for any injury. Knowing you have surgical options at Lowell General Hospital offers the next step towards getting back into action.