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| ACL reconstruction (Arthroscopic reconstruction) |
| Timing of surgery |
| ACL reconstruction
I prefer to do this as soon as possible after the diagnosis is made. The optimal time is three weeks. The advantages of the early arthroscopy and surgery are that it allows a peripheral tear of the meniscus to be sutured. |
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| Technique |
| I prefer to do ARTHROSCOPIC ACL reconstruction as the incidence of postoperative neuromas of the infrapatellar branch of the saphenous nerve is less through a 2-incision harvest of the patellar tendon and visualization of the bony tunnels is accurate. I prefer the patellar tendon as a graft, although recent reports have found no significant difference between patellar tendon and hamstring grafts. In a revision reconstruction I may choose to use allograft if available.
Orthopaedicians in India do not see many knee injuries in sportsmen but more injuries in two wheeler accidents.
Arthroscopically I can inspect the rest of the knee for concomitant damage. Meniscal and cartilage tears can be addressed arthroscopically.
I use the patellar tendon routinely and the hamstrings tendons occasionally. |
| post operatve regime |
| My postoperative regime aims at achieving knee extension first and then goes on to the rest of the regimen. The patient can return to his normal level of activity by one year.
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