Reconstruction

Reconstructive procedures include those where ligamentous structures (ACL, PCL, LCL, MCL, PCL, PLC) are repaired or rebuilt using the patient’s own tissue and various reconstructive devices (RCI screws, bone staples, fixation posts, endobuttons). Occasionally patients require more than 3 ligaments (multiligament reconstruction) to be reconstructed at once, or previously reconstructed ligaments that have subsequently failed to be reconstructed again (revision ligament reconstruction) and depending on patients circumstances and their own tissue availability, occasionally donor tissue (allograft) or a synthetic ligament (LARS) may be considered for use. If the knee problems are being contributed to by a malalignment, the reconstructive techniques may include realignment using a combination of soft tissue releases and advances (patellofemoral realignment) or bony cuts or osteotomies to the tibia (HTO), femur (DFO) or tibial tuberosity (TTO) with internal fixation using metallic devices (screws, plates) and where necessary, bone grafting. These are generally larger operations, designed to alleviate instability, pain, swelling and to restore confidence with the knee, for both day to day activities and higher demand physical duties, including manual physical labour and sporting activities. Finally, for those patients with unicompartmental (most often medial compartment) arthritis and a deficient ACL, as an alternative to a total knee replacement (TKR), a combined ACL reconstruction and HTO can be considered as a joint preserving or “salvage” procedure.

  • ACLHERO

    ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION

    The Anterior Cruciate Ligament (ACL) is a cord of tissue in the middle of the knee connecting the femur and tibia, and acts as a key stabiliser for rotation and change in direction activities ...

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  • pcl hero

    POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION (PCL)

    The Posterior Cruciate Ligament (PCL) is a cord of tissue at the rear of the knee connecting the femur to the tibia which acts as a key stabiliser when performing movements going forwards ...

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  • collateral hero

    COLLATERAL (LCL, MCL) & POSTERO LATERAL CORNER (PLC) LIGAMENT RECONSTRUCTION

    The Lateral Collateral Ligament (LCL) is a cord like structure which runs on the outside or lateral aspect of the knee from the femur down to the fibula, not actually attaching to the tibia ...

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  • multi hero

    MULTILIGAMENT RECONSTRUCTION

    It is uncommon to sustain 3 or more ligament injuries to the knee and should this occur, the knee function is likely to suffer significantly. It usually requires a high energy injury, such as...

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  • rev recon hero

    REVISION KNEE RECONSTRUCTION

    In general terms, the risk of failure of a reconstructed knee ligaments is low. The most common knee ligament reconstruction is the ACL reconstruction, with the incidence of ACL rupture...

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  • pat stab hero

    PATELLOFEMORAL REALIGNMENT & STABILISATION

    The patella or "knee cap" is a small but very important bone which actually endures more force across it than any other bone in the human body. It also travels up and down the knee...

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  • hto hero

    OSTEOTOMY – HIGH TIBIAL (HTO), DISTAL FEMORAL (DFO), TIBIAL TUBERCLE (TTO)

    The knee is a large joint divided into three compartments which are termed as the inner or medial compartment, the outer or lateral compartment and the frontal or patellofemoral compartment...

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  • combin1

    COMBINED ACL RECONSTRUCTION AND OSTEOTOMY (ACL & HTO)

    Patients who have both medial compartment arthritis of the knee and anterior cruciate ligament deficiency can experience symptoms of both arthritis (pain, swelling, stiffness) and instability (giving way with change in ...

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