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    •         Ligament 
     
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        ANTERIOR   
        CRUCIATE  
        LIGAMENT 
    		  
     
    1. Anatomy and Function:    The  Anterior Cruciate Ligament  
            (A.C.L.) is the most important ligament in the knee.  It joins  
            the femur to the tibia at the center of the joint and prevents  
            shifting movements during activity. 

    2. Injury:     The  A.C.L. is injured when the knee is twisted under  
             load, angled to the side or hyper extended.  This can occur  
             during a fall, rapid deceleration, pivot or collision.  The  
             ligament usually ruptures or tears at it's mid portion which  
             renders it non-functional and creates an unstable knee. 

    3. Treatment:    The torn A.C.L. has very poor healing potential  
            and therefore cannot be repaired.  The choices are: a) replace  
            the ligament or b) live without an A.C.L. The following  
            criteria are used to arrive at a decision: 
                 a) Patient age 
                 b) Activity goals 
                 c) Associated injuries 
                 d) Degree of instability 

            NON SURGICAL treatment begins with rehabilitative  
            exercises to strengthen the leg followed by the use of a custom  
            knee brace for all strenuous activities.  

            SURGICAL treatment consists of an arthroscopic procedure  
            to replace the torn A.C.L. First, the entire knee is examined to  
            identify torn cartilage or other problems that need to be  
            addressed. Then the torn A.C.L. is removed and the area is  
            prepared to accept a tendon graft replacement. The choice of  
            graft includes: 
     
    a) Patellar tendon 
    b) Hamstring tendons 
    c) Cadaver tendons
            The surgery is performed as an outpatient procedure and lasts  
            about two hours. The patient begins rehabilitation almost  
            immediately and gradually increases their activities until full  
            recovery is achieved at 6 months post-op.  

            This operation, although extensive, will restore the knee to  
            over 95% of its pre injury function. 
           --                                                     -- 
            Dr. Yacobucci has performed over 3000 of these A.C.L.  
            reconstructions and uses state of the art techniques and  
            instrumentation. He has extensive training in this area and is  
            actively involved in clinical research related to this procedure. 
      


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