Complex Knee Ligament Reconstruction (ACL, PCL, MCL, LCL)

Complex knee ligament reconstruction is the surgical process of repairing tears in one or more of the four main ligaments found in the knee:  the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL).  Ligaments help control joint movement, so a frequent cause of knee ligament damage is a high-energy athletic mishap.  More extensive injury to the ligaments can also be the result of a “high energy” injury such as a car or motorcycle accident.

The first symptom of a torn ligament can be a popping feeling in the knee followed by the feeling of the knee “giving out.”  Swelling and pain can follow.  During the physical exam, Dr. Van Thiel looks for instabilities in the knee and may apply stress to the ligaments to identify the origin of the problem.  An MRI may also be used to verify ligament tears and to identify any additional damage that may have occurred in the knee.

While a patient may elect to leave a torn ligament untreated, the resulting knee instability will require lifelong restrictions in the types of activities they may perform and can include continued discomfort in the knee.  Surgical repair can restore the patient’s function and eliminate the cause of knee pain.  Two techniques may be used to reconstruct the damaged ligaments.  For young highly active patients an “autograft” is typically used to reconstruct the torn ligament.  An “autograft” is the use of another tendon (patellar or hamstring tendon) from the patient to complete the surgical repair.  In patients that are interested in a quicker recovery and do not participate in high level competitive athletics, and “allograft” ligament can be used.  An “allograft” is a ligament from a donor that can then be used to restore function in a patient’s knee.

Following complex knee ligament reconstruction, patients will frequently be given a brace to help support the knee during healing, and physical therapy will be prescribed.  In addition to helping restore knee function, physical therapy and home exercises help condition and build strength that can prevent future injuries.