Patient 12

A 33 year old male sustained an injury to his left knee while playing football, 4 days prior to presentation at the Fracture and Orthopaedic Clinic. He complained that he felt something “slip”. He experienced pain and buckling and also stated that he had a problem with instability of his left knee since his injury. He has a history of a meniscal injury in 2008. On physical examination by one of our experienced Orthopaedic Consultants, there was found to be antero-posterior laxity( slipping of knee back and forth) of his left knee joint, however this was difficult to define. There were no signs of meniscal injury and no swelling present. X-rays done showed no abnormalities of the bones. A provisional diagnosis of Posterior Cruciate Ligament Rupture grade I with or without damage to the meniscus was made. An MRI of his left knee was subsequently done, which showed a complete anterior cruciate ligament (ACL) tear, lateral meniscus horizontal tear and also a medial meniscal tear.

The decision was taken to an arthroscopy (camera)/exploration of the left knee, with subsequent Anterior Cruciate ligament reconstruction using autograft (tissue from the patient). The autograft used was a bone-patellar bone graft taken from the patient’s knee (see pictures). On insertion of the camera and exploration of his left knee, a complete tear of the ACL was noted. All other structures in the knee remained intact(contradictory to the MRI impressions). The bone patellar bone graft was taken and fixed in position with 2 screws. The knee was tested and found to have full range of motion at the time of surgery. The patient was then placed in a knee immobilizer, was sent to physiotherapy and allowed to full weight-bear on his left leg.

One month post op, the patient has full range of motion of his left knee. The knee is stable and his post-op swelling has decreased. He is showing positive signs of recovery as he is tolerating physiotherapy well and as a result, has increased the intensity of his exercises. He is currently continuing his follow up with us to monitor his improvements.

Please take a look at our "VIDEO GALLERY" section on our website to view an animation of the entire procedure described above.- VIDEO GALLERY--> KNEE--> TORN ACL- bone patellar tendon bone graft.

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