Ligament Reconstruction
There are four main ligaments in the knee joint. The two intra-articular (inside the joint) ligaments are the anterior and posterior cruciate ligaments (ACL/PCL). There are also two ligamentous complexes on the inside and outside of the knee joint: the MCL with POL, and the LCL with PLC. These structures can be injured individually or in combination, depending on the severity of the force and the position of the knee at the time of injury.
ACL & PCL Injuries
The ACL and PCL are key stabilizing ligaments inside the knee and are commonly reconstructed arthroscopically to restore stability and movement.
Collateral Ligament Complexes
The MCL + POL and LCL + PLC complexes support the inner and outer sides of the knee and may be injured alone or along with cruciate ligament damage.
Graft Reconstruction
Reconstruction is usually performed using one of your own tendons from the inside of the lower thigh, prepared into a graft and fixed with small titanium buttons to the tibia and femur.
Revision Surgery Expertise
In cases where ligament reconstruction has failed, quadriceps tendon or patellar tendon grafts may be used with screws for repeat reconstruction.
Advanced Ligament Reconstruction Techniques
The ACL and PCL are repaired or reconstructed arthroscopically. For reconstruction, I use one of your own tendons from the inside of the lower thigh and create a graft that is looped through and fixed with small titanium buttons to the tibia and femur.
In cases where ligament reconstruction fails, I use the quadriceps tendon or the patellar tendon graft along with screws to reconstruct the ligament again.
I prefer a biological all-inside ACL reconstruction in my patients for better healing of the implanted graft. I am also an expert in minimally invasive extra-articular knee surgeries, such as percutaneous PCL reconstruction, MCL internal bracing or repair, and POL advancement.
Return to Active Life and Sports
Most patients are able to walk unaided and comfortably within 2 to 4 weeks after surgery, except in cases of meniscal repair where avoiding weight-bearing for 6 weeks is usually advised.
Light impact activities such as jogging can usually begin in 4 to 6 months, while training for return to sporting activities generally starts in 7 to 8 months.
In most cases, it takes at least 9 months to return to impact sports such as football after ACL or PCL reconstruction. Premature return can lead to complications. It is essential to allow the new ligament to mature fully, and return to sports should only happen once the operated knee is as strong as, or stronger than, the non-operated knee. Studies have shown that beginning sports too early can lead to a 7 times higher risk of graft failure.
2–4 Weeks
Walking comfortably without support in most routine cases.
4–6 Months
Light impact activities such as jogging may begin.
7–9+ Months
Sports training starts around 7–8 months, with full return to impact sports usually after 9 months or more.