The knee joint consists of the femur (thigh bone), tibia and fibula (shin bones), and patella (knee cap). This complex joint is stabilized and held together by four major ligaments, one of which is the anterior cruciate ligament (ACL). The ACL runs diagonally across the middle of the front of the knee. The posterior cruciate ligament (PCL) is similarly positioned in the back of the knee; together the two ligaments form an X under the kneecap.
The severity of the ligament injury is usually what determines whether surgery will be necessary. Other factors that may affect the choice of treatment are how active a patient is and whether the knee is unstable. A partially torn ACL may heal over a period of several months and minor PCL tears often heal quite well. However, if the knee is unstable, it tends to increase the risk of re-injury and may cause significant pain. A completely torn ligament is unlikely to heal and is usually treated with surgery.
An ACL reconstruction is a surgical procedure to repair the ACL after an injury. It is usually performed under general anesthesia. The surgeon uses a piece of tissue from somewhere else in the patient's body or a donor graft from someone else to replace/repair the damaged ligament. The new ligament is attached with screws. ACL reconstruction can often be performed with the use of a special camera called an arthroscope and instruments inserted through small incisions.
When surgery is required to repair the PCL, it often means the knee has sustained considerable trauma and other structures may be damaged. Sewing the torn ends of a ligament together doesn't work, so the surgeon will use a tissue graft from your body or a donor. Like an ACL reconstruction, a PCL reconstruction is often done with an arthroscope.
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