It’s a common repair for athletes of all abilities, ACL reconstruction. Surgeons are always upping their game when it comes to technique and that means patients get the win.
Dr. Mark Bowen, orthopedic surgeon with NorthShore University HealthSystem, says there are many activities people engage in that get them into trouble with their knees, and specifically ACL injuries.
An anterior cruciate ligament, or ACL tear, is an injury orthopedic surgeon Dr. Mark Bowen sees in all age groups and at all levels of activity and athleticism.
“Probably the most visible are the sports that involve a lot of cutting and twisting, like soccer and basketball and football,” Bowen said.
It was a flag football game that took out Billy Dalakouras. It was his second ACL tear in the same knee. Dalakouras tells WGN, “I planted my foot, very familiar feeling. Bottom of leg goes one way, top goes the other. I felt a very small pop.”
Dr. Bowen explains, “It’s the torque. The upper bone rotates aggressively on the lower bone.”
Patients have a few choices when it comes to reconstructing the torn ligament. They can opt to use part of their own patella tendon , which requires a larger incision in the knee, or a donor graft, a tendon taken from a cadaver.
Dr. Bowen says “The advantage of tissue from outside, from a donor, is that it is taken out of the freezer, thawed and put in your knee. And so the incisions and trauma to your knee are absolutely the least. The disadvantage is that over time the results of those surgeries have been mixed. The re-tear rate, in my opinion, has proven to be unacceptably high compared to using your own tissue. It’s probably as high as 10 to 20 percent in cadaver grafts.”
That’s why the hamstring, and a novel way of attaching it in the knee, is so appealing to Dr. Bowen. “It has less trauma than using the patella tendon yet it’s your own tissue.”
After his first tear, Dalakouras opted for a donor graft. This time around he took a different path and noticed a “drastic difference.”
First, Dr. Bowen made a small incision to access the hamstring, the same incision he uses later in the operation to attach the graft.
“The key features were to take only one hamstring and quadruple it so make it the thickness of four. It’s a very strong tendon. It’s actually stronger than the patella tendon. What hasn’t been as strong is the fixing of it, but this is,” says Bowen.
Dalakouras says following this procedure he felt stronger quicker. “I mean, it was really night and day.”
Dr. Bowen says the re-tear rate with his hamstring procedure is one to two percent, as good as prior options. If you’d like to learn more about the CoLS hamstring procedure, go to www.northshore.org/sports or call 847-6-SPORTS or 847-677-6787