I injured my cruciate ligament in May 2007 playing soccer on an astro-turf pitch while chasing after a ball and stopping suddenly. I’ve not played hurling competitively since October 2006, apart from 1hr and 30 mins at intermediate level in 2008.
The problem with an Anterior Cruciate Ligament (ACL) injury is that the knee becomes unstable. So despite my best efforts to become fit and build the strength of my quad and hamstring muscles around the joint, alas the knee just buckles under a sudden change of direction. The “buckling” of the knee is painful but even worse leaves a deep psychological scar and even watching other people jump and land on one leg now makes me queasy at the thoughts of ever doing it myself.
Fortunately the success rate is now up to 90% for ACL reconstruction, that is 90% of knees repaired are “clinically stable” after the operation. Now we all know there are lots of people with recurrence, however a lot of these cases are due to rushing back into competitive action and not giving the injury a proper chance to heal. I’m going to take a full 9 months away from the hurling/soccer fields.
The big question with an ACL operation is which way to do it, after all there are 3 entirely different methods:
- Patellar Graft: A strip of tendon with 2 chips of bone at either end is taken from the knee-cap/shin and grafted into the knee as a straight replacement for the ACL.
- Hamstring Graft: More complex procedure where a section of the hamstring is removed and joined into the knee by drilling holes through the bone. Modern techniques make a plat of the muscle to increase strength.
- Donor Graft: An intact ACL is taken from a cadaver (corpse) and grafted into place. Apparently the techniques have imrpoved greatly and its a very simple operation technically. Weird too though!
The operations above all work, but there are pros and cons to each. There seemed to be no definitive concensus on which is the method of choice, with the highest success rate and least problems.
I sought professional guidance on the matter and to my delight today I received a crystal clear response from a highly regarded physiotherapist:
Most surgeons seem to be performing the hams graft these days. The failure force of the patellar tendon is technically higher than that of the hamstring graft but the hamstring graft is associated with much less post operative soreness and complications, and quicker recovery of quads strength.
So there you have it, the hamstring is the best bet in 2009 for a successful ACL operation and recovery.
I’m in for my op on June 11th so looking forward to it now.
2010 Update: I have been tracking my post-op recovery here: Me and My Knee