Advances in ACL Surgery: Anatomic Reconstruction

This summer, John Vitolo, M.D. attended a conference on a new ACL reconstruction technique at the University of Pittsburgh Medical Center, home to one of the largest and most respected orthopedic clinical and research departments in the United States.  Dr. Vitolo is now one of a few specialized orthopedic surgeons trained in this new surgical technique, called the “Anatomic ACL Reconstruction Method”.  

Since adopting this new procedure, Dr. Vitolo has noticed that his patients experience less post-operative pain, improved range of motion and better overall results.  Dr. Vitolo stated, “Anatomic method takes each patient’s individual anatomy into consideration and attempts to restore that natural anatomy.  By using a medial portal approach, you are able to put the new graft where the original ligament existed.  The results have been phenomenal.  Post-operative pain has decreased and my patients are recovering more quickly and returning to activities faster.”

The anatomy of every patient is different.  The “Anatomic Technique for ACL Reconstruction” looks at each patient individually and anchors the ACL to its original anatomical position by using the medial portal approach; therefore keeping the natural anatomy of the knee.  By doing this, the patient is less likely to suffer a repeat tear and is able to return to activities in less time.  It is also believed that using this new method can decrease  the risk of developing arthritis later in life. 

When the ACL is injured it cannot be repaired by fixing the original ligament.  A “new” ACL must be constructed by grafting tissue from the patient’s body (autograph) or by using tissue from a cadaver (allograft).  It has been shown that anatomic graft placement is critical to the success and clinical outcome of ACL reconstruction.

The main benefit to the new procedure is that it helps prevent a re-tear of the ACL because the graft is placed lower and mimics the body’s natural anatomy.  Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction.  

For more information or to schedule an appointment, please visit our website:  www.skyvieworthopedic.com or call 973.300.1553.   

Dodging ACL Injury on the Slopes

Here’s the scenario: twilight, it’s the last run of the day, you are tired and wobbly and as you get off the lift you veer to the right to avoid the two snowboarders fastening their bindings in front of you. Your leg goes one way, your knee the other; you hear an unsettling pop and a sudden sharp pain on the inside of your knee. Congratulations, you just tore your ACL.  For skiers, the dreaded ACL injury, the most common ski injury, can mean missing out on an entire ski season and a trip to the hospital, rather than tomorrow’s corduroy.    

You may be wondering what the ACL is and why is it such a common ski injury?  The Anterior Crutiate Ligament (ACL) is one of the four ligaments of the knee that connect the femur and tibia.  The ACL runs diagonally across the middle of the knee and prevents the tibia from sliding out in front of the femur.  It also provides the knee with the ability to rotate.  

For skiers there are 2 main ways an ACL tear occurs.  The first is a sudden stop or acceleration of the leg, resulting in a tear.  The other more common cause of a tear is when the leg (or ski) stays in place, while the rest of the body stays in motion.  Symptoms of an ACL tear may include a popping sound, swelling of the knee, pain and instability. 

ACL injuries happen suddenly and often without warning, but according to Vermont Ski Safety (www.vermontskisafety.com), there are precautions that can be taken to help prevent them.   Resorts using the training & techniques offered by Vermont Ski Safety have seen a 50% drop in ACL injuries.  Also, according to Ski Magazine, new bindings are now available that can release directly at the heel and are expected to reduce knee injuries. 

Tips for on the Slopes:

1.       Overall follow the responsibility code and maintain balance and control.

2.       When you fall, keep your knees bent with skis parallel and together.  Also allow yourself to finish the fall -- don’t try to stop sliding with your ski edge.

3.       If you jump, know how and where to land – land on BOTH skis and keep knees flexed

4.       Use newer ski bindings that were designed to reduce knee injury.

5.       Stay hydrated and well nourished – this will increase your awareness on the slopes and help you avoid potentially dangerous situations.

Off the slopes:

1.       Strengthen hamstring muscles and muscles around the hips. 

2.       Keep your equipment in good shape and have bindings checked regularly.

3.       Work your upper body – knee injuries often are a result of the upper body becoming tired and letting poles drop behind.

4.       Work your core muscles.

5.       Cross-train, stay fit and eat a balanced diet. 

For more information and videos from Vermont Safety Research, please visit their website.  If you do suspect an ACL injury see a doctor.  Skyview Orthopedic, the office of John Vitolo, M.D., has locations in Sparta and Randolph.  Dr. Vitolo holds dual board certification in Orthopedic Surgery and Sports Medicine.  He specializes in arthroscopic surgery of the shoulder and knee.  Visit the website:  www.skyvieworthopedic.com or call 973.300.1553 for more information or to schedule an appointment.  Find us on Facebook at www.facebook.com/skyvieworthopedic.

References:  1..www.vermontskisafety.com  2.www.livestrong.com  3.  www.skinet.com/ski



John Vitolo, M.D.