Acl Reconstruction With A Bone-patellar Tendon-bone (Bptb) Graft

What is an ACL ligament reconstruction?

An anterior cruciate ligament (ACL) is a ligament in the knee that provides knee joint stability. The ACL ligament is commonly injured while participating in high-intensity sports. ACL reconstruction surgery is normally indicated to restore knee strength and function by reconstructing the damaged ACL ligament with a bone-patellar tendon-bone (BPTB) graft. The BPTB graft may be obtained from the tendon that is responsible for stabilising the kneecap or patella. This tendon is called a bone-patella tendon-bone graft, also known as a BPTB graft, which consists of a tendon and bony attachments.

ACL reconstruction is normally indicated for knee injuries that involve the ACL ligament. ACL ligaments are susceptible to complete or partial tears that may require surgical reconstruction with a graft from a tendon on the body. The graft helps prevent instability while restoring function to the knee. The bone-patella tendon-bone graft is highly recommended because it provides durability and longevity of the joint and helps you to return to a high level of activity.

How does Dr van Niekerk perform ACL reconstruction with a bone-patellar tendon-bone (BPTB) graft?

ACL reconstruction is normally performed 3-8 weeks after swelling has subsided and you have obtained a certain level of mobility. The patellar tendon will be examined before the procedure to determine whether or not it is fit to be used as a graft during the procedure.

Dr van Niekerk makes tiny incisions on the knee. He passes an arthroscope, a tube that has a small camera attached to its end, through an incision to view the inside of the knee joint. A sterile solution will then be pumped into the knee to expand it, allowing the orthopaedic surgeon to look inside the joint clearly. He then removes the torn ACL and prepares a pathway for the new ACL graft.

Holes will be drilled into the upper and lower leg bones called the tibia and femur, the bones that converge at the knee joint. The graft will be inserted through the holes and fixed into the bone using screws to help hold the graft as the ligaments heal into the bone. After the procedure, the incisions will be closed using sutures.

What is recovery like?

After surgery, ACL rehabilitation begins. Usually, a physical therapist is recommended. Your physical therapist will teach you certain exercises to help strengthen the leg and restore leg movement. Competitive sports should be avoided for at least 5-6 months after surgery to allow the graft to incorporate into the knee joint.


What are the associated risks and complications?

The possible risks and complications may include the following:

  • Infection
  • Blood clots
  • Numbness
  • Pain in the knee
  • Recurrence of injury to the graft
  • Failure of the graft
  • Nerve and blood vessel damage
What are the most obvious signs of an ACL injury?

An ACL injury may cause symptoms like a loud popping sound and buckling at the knee. You may have swelling caused by the bleeding in the torn ligament. Your knee may also feel unstable or seem to give away, especially when you are trying to change direction.

What causes an ACL injury?

ACL injuries commonly occur during sports activities that may involve twisting or overextending the knee. Other causes may include the following:

  • Slowing down while running.
  • A direct blow to one side of your knee, such as during a football tackle.
  • Sudden directional change.
  • Landing from a jump incorrectly.