An Interview with Professor Paul Lee for Doctify
ACL reconstruction is a common repair for athletes of all abilities. Surgeons are always upping their game when it comes to technique, meaning patients can keep getting the win!
Prof. Paul Lee, consultant orthopaedic surgeon and Professor of sports medicine at MSK Doctors tells Doctify how there are many activities that can get you into trouble with your knees and other ACL injuries & what your options are.
What is ACL?
Prof. Paul Lee: ‘An anterior cruciate ligament or ACL tear is a sports injury seen in all age groups and at all levels of activity and athleticism.
It affects the sports that involve a lot of cutting and twisting, like football, rugby and netball.’
What Does it Feel Like?
Prof Paul Lee: ‘ You can be participating in sport and plant your foot in a very familiar position but the bottom part of your leg goes one way and the top goes the other. Often a popping sensation is felt and your knee will come out from under you.
The twisting motion creates torque and the thigh bone rotates aggressively on the shin bone causing the pop, instability and often swelling within the next few hours.’
What is ACL Reconstruction?
ACL Reconstruction aims to replace the tron ACL with a tendon, which will act as an internal brace to stop the knee rotating uncontrollably and giving way. There are many types of reconstruction methods and not all have the same result.
What Are the Pitfalls with ACL Reconstructions?
Patients have many choices when it comes to reconstructing the torn ligament. There are so many variations ranging from fixation method and graft choice. They can opt to use part of their own patella tendon (the tendon connecting the bottom of your knee to your shin bone), which requires a larger incision in the knee and can often lead to chronic pain in the front of the knee, or a tendon taken from a cadaver.
Prof. Paul Lee: ‘The advantage of a donor graft (cadaver) is that it is taken out of the freezer. So the incisions and trauma to your knee are absolutely minimal. The problem is that although the graft has been screened, it is never 100%. Also the re-tear rate, in my opinion, has proven to be unacceptably high compared to using your own tissues. It is probably 20% higher in comparison to using your own tissues.’
What is the Best Option?
This is why the single hamstring tendon and a novel way of attaching the tendon to the knee (TLS system) are so appealing to Prof. Lee, ‘It is less traumatic than using the patella tendon and therefore avoids the issue on subsequent anterior knee pain, yet it is your own tissue!’
This alternative solution allows Prof. Lee initially making a small incision to access the hamstring and then later using the same incision during the operation to attach the tendon.
Prof. Lee: ‘The key features of this surgical procedure are to take only one hamstring and quadruple it so as to make it the thickness of four. It’s a very strong tendon, actually stronger than the patella tendon and so a good option in order to avoid unnecessary knee pain at a later date.’
‘What’s more important is that this system allows early rehab and has more than 13 years of great clinical results!’.
If you are experiencing the signs and symptoms of an ACL injury, it is time to see a specialist and get back to the top of your game!
