A fertilized anterior cruciate ligament (ACL) reconstruction is a fairly new approach to a very common knee surgery. The anterior cruciate ligament is one of the most frequently injured knee ligaments in young athletes. A typical ACL reconstruction surgery requires around nine months of recovery time before an athlete, or an individual can get back to moving normally. With a fertilized ACL reconstruction, it is believed that an individual can get back to performing at full capacity within six months and be able to move without limitation at that time.
Fertilized ACL reconstructions use three main ingredients that make them different from a traditional ACL reconstruction. The combination of these three ingredients is shown to facilitate rapid healing and get the patient back to normal in less time. These three ingredients are:
- Autologous platelet-rich plasma (PRP) – A blood product obtained from the patient’s own body that has an increased concentration of platelets. This has been shown to reduce inflammation and facilitate healing in soft tissue and bone.
- Demineralized bone matrix – Allograft bone (bone not taken from the patient receiving the procedure) is put through an acid extraction process that removes the inorganic material but leaves the collagen matrix behind. This helps support new tissue growth.
- Autograft bone – A sample of the patient’s own bone tissue taken from somewhere in the body before the procedure, usually the top of the hip bone. This provides a framework that healthy tissue can grow around.
These three materials are combined to create a “joint fertilizer” of sorts that helps expedite the healing process. This fertilizer is used in tandem with a traditional reconstruction procedure, as well as what is called an internal brace, which is a piece of biocompatible polymer that offers extra stability to the damaged area while the body’s natural healing takes place.
Anterior Cruciate Ligament (ACL) Tear
There are four major ligaments in the knee that connect the femur to the tibia. These ligaments work together tocreate a strong and stable hinge joint that we use to walk, run, squat, jump and much more. The ACL specifically is located towards the center of the knee and its function is to limit rotational movement and prevent the tibia from moving too far forward.
There are many symptoms that can come with an ACL tear, and without a proper medical assessment you likelywon’t be able to know if yours is torn for sure. There are a few signs to look out for. Typically, an ACL tear will come with a loud and audible popping sound in the knee joint followed by:
- Severe pain
- Rapid swelling
- Feeling of instability
- Limited range of motion
- Loose feeling in the knee joint
Note that any of these symptoms can be seen independent of a tear in the ACL but if a loud pop is heard and any number of these symptoms appear then a tear is possible.
ACL tears are a very common sports and exercise injury, but they can happen outside the field of play as well. Some things that can cause an ACL to tear are:
- Sudden cutting/change of direction
- Sudden stopping
- Unstable landing from a jump
- Collision or harsh contact to knee
- Planting the foot firmly and pivoting
To properly determine whether an ACL is torn a doctor will need to perform an assessment. The doctor will usually start by checking your knee for swelling and tenderness, then carefully assess your range of motion. A Lachman test is an examination technique that is typically regarded as the most accurate and specific method of diagnosing ACL injuries. It uses a carefully selected set of positions to determine the extent of the injury. It is likely that yourdoctor will perform this test or something similar during your assessment. From there it is common to schedule anMRI so that the doctor can see what is going on below the surface in greater detail. After the assessment, if yourdoctor thinks that a reconstruction surgery is necessary, a fertilized ACL reconstruction is the most cutting-edge technique available.
Depending on your age, medical history, and the specific details of your injury a few more tests might be necessary to ensure you are eligible. This could include blood tests, an overview of your current prescription medications, and tests for heart and lung disease. If you regularly consume tobacco or alcohol, it will also be necessary for you torefrain from doing so leading up to your surgery.
Fertilized Anterior Cruciate Ligament (ACL) Reconstruction
The process for a fertilized ACL reconstruction is as follows:
- 2-3 quarter inch incisions will be made around the knee.
- An arthroscope is inserted to give the doctor a clear view of what’s going on below the skin. This is basically a thin flexible camera that displays a live feed on a monitor in the operating room.
- A sterile solution is pumped into the knee to expand the joint giving the surgeon more working space.
- The torn ACL is removed.
- The joint is then prepped for an ACL graft.
- Small holes are drilled into the femur and tibia to give the graft entry points to attach to
- The graft is pulled through the holes and secured with screws or anchors.
- An injection of fertilized ACL is administered into the predrilled holes which contains a bone autograft, demineralized bone matrix, and autologous PRP from the patient’s own body. This is what helps expedite the healing process.
- Next an internal brace will be attached over the ACL for added support.
- Finally, the arthroscope is removed and the incisions are sutured.
After your surgery you will be taken into a recovery room where you will be monitored until your team of doctors clears you for release. You will be unable to drive yourself home so proper accommodations should be made beforehand. From there the recovery process looks different for everyone but you will typically be able to begin physical therapy within the first week. The benefits of a fertilized ACL reconstruction should be apparent to you in the coming months.
They are shown to heal quicker, be less painful post operation, and allow for more uninhibited movement in thejoint. As the fertilizer does its job, the body begins to heal, and you notice more strength in the previously compromised joint, it is important to keep up with your physical therapy exercises and make sure not to push yourself more than your doctor recommends. A series of follow up consultations will likely be scheduled to keeptrack of your progress but within 6 months you should notice yourself getting back to normal.
If you have any questions regarding an ACL injury or would like to learn more about this cutting-edge procedure, please give us a call. We would love to set up a consultation and look forward to providing you with the best care possible.