How is the ligament fixed?
Older techniques consisted of sewing the torn ends of the ligament back together. This relatively simple operation didnt work and the ligament almost always tore again. The standard operation is now reconstruction of the ligament where another tendon is used as a replacement for the anterior cruciate ligament. There are three main choices for this substitute tendon. These are the central third of the patellar tendon (the tendon which runs from the knee cap to the shin bone), two of the hamstring tendons (the tendons behind the thigh), or a tendon from an organ donor. There are pros and cons to each. The patellar tendon has been used for years, provides a strong replacement for the ACL and can be securely fixed in place in the knee. However, use of this graft has a higher chance of side effects consisting primarily of pain/inflammation/tendonitis in the region of the patella and the patellar tendon. This is particularly a problem in those that need to kneel or crawl such as wrestlers, c
