ACL Reconstruction/Repair Surgery

The Anterior Cruciate Ligament (ACL) is located in the center of the knee joint, connecting the femur (thigh bone) to the tibia (shin bone). It is the major stabilizing ligament of the knee. When the knee bends it does not simply flex and extend (bend and straighten), there is also a rotational component to the movement. This anatomical detail was discovered only in the past 50 years and is a process for which a healthy ACL is dependent. The ACL prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur) and stabilizes the knee's rotational movement, allowing us to pivot and change direction as we walk and run.

As the complex rotational movement of the first knee became well understood in the 1960s, knee injuries to military recruits were addressed with ACL surgery using open incision and repair of torn ACLs, an in-patient procedure requiring long periods of rehabilitation and post-operative physical therapy.

Over time, surgeons discovered that reconstruction of the ACL offers better long-term outcomes than repair, and most injuries to this ligament are addressed today with ACL surgery using tendon material taken from the patellar tendon or the hamstring to replace the torn ACL. Advances in surgical technique also permit modern ACL reconstruction using minimally invasive arthroscopy, avoiding the necessity for open incisions and immobilization of the knee for up to six weeks in a long full-leg cast that were once common. Today some ACL surgery patients do not even require a brace and are able to put weight on the leg as tolerated right away.

At Hospital Angeles Tijuana, Dr. Garin has treated hundreds of ACL injuries and performs ACL surgery as a regular component of his work as the team doctor for professional soccer and baseball teams.