Now Playing: What Happens During ACL Reconstruction? (Bone-Patellar-Bone)
ACL Reconstruction (BPB Graft) Video Presentation
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After the anesthesia is given, a tourniquet or blood pressure cuff is usually wrapped around your thigh to temporarily stop the flow of blood to your knee. This allows your doctor to see the surgical area clearly.
To help reduce the chance of infection, the area will be scrubbed with a special soap, and you will be covered with sterile sheets. The only area exposed will be the site where the procedure is being performed.
Your doctor will begin the surgery by making three small incisions about a quarter inch in length. One is located above the kneecap and the other two are below. Your knee is then filled with fluid to expand the joint so that your doctor can see better inside. Through one of the incisions, the arthroscope is then inserted. Once the arthroscope is in the correct position, your doctor will begin to examine the structures of your knee on a video monitor, looking for any damage to the menisci or articular cartilage. If an injury is seen, your doctor will treat it at that time. When the cartilage work is done, your doctor will then proceed with the ACL reconstruction.
Your doctor will first remove the torn ends of your ACL. It will then be replaced with an ACL graft from your patellar tendon. To do this, another incision is made in the front of your knee and one-third of the patellar tendon with a piece of bone attached to either end is removed. Because this graft is taken from the middle of the patellar tendon, the tendon is reattached with stitches that your body will absorb over time. There are no long-term defects after taking the graft from this location.
A tunnel where the graft will eventually go is created, starting in the shinbone, through the knee and into the thigh bone. The graft is then placed into the tunnel and usually secured into place with two screws, one in the shinbone and the other in the thighbone.
After your doctor has completed the work within your knee all of the instruments will be removed and the fluid will be drained. The skin incisions will be closed using stitches and a sterile bandage will be applied. A hinged knee brace may be placed to lock your knee in a straight position.
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