Each year, in the United States alone, it is estimated that one in every 3,000 people sustains a ruptured or torn anterior cruciate ligament (ACL) due to trauma or sporting injuries. For most patients, the pain is excruciating and the road to recovery is long.
On Thursday, Sept. 27, at 5:30 p.m. CST, during a live global Webcast from the Sports Medicine Institute at Memorial Hermann in Houston, orthopedic surgeon Mark Adickes, MD will perform an innovative ACL reconstruction surgery designed to hasten rehabilitation and recovery time.
"For patients, the typical goal is to return to activities quickly and without pain, but, if they're going to have reconstruction surgery, the repair should be durable and should allow them to return to normal activity without limitations," said Adickes. "The All-Inside RetroConstruction procedure is minimally invasive and achieves all of these goals."
Adickes, a former NFL offensive lineman and member of the 1991 Super Bowl Championship Washington Redskins team, is one of the original three surgeons in the country to perform this new technique. Having had two ACL procedures himself and experiencing 18-month recoveries, he was determined to find advanced surgical solutions for his patients.
"The results my patients are getting from this procedure are dramatic," said Adickes. "Recovery time has been reduced, and there is less pain because there's not the damage to the tissue that a standard ACL reconstruction can cause."
During the Webcast, Adickes will perform a diagnostic arthroscopy on the knee joint. He will then remove the torn ACL and determine if a notchplasty is needed. In some patients, the "notch" where the ACL is located is extremely narrow. To decrease the probability of injury to the newly reconstructed ACL, the notch may need to widened.
Once the femur is prepared, Dr. Adickes will drill the femoral tunnel and place a suture through the tunnel for later graft passage. After making a small stab incision in the skin, a threaded guide wire is placed through the tibia. Once the guide wire is in position, the surgeon will drill the tibial tunnel by fitting the drill bit onto the guide wire in the joint. The drill bit is then advanced through the tibial bone to the appropriate depth and then removed from the guide pin by putting the drill on reverse.
"The standard procedure is to drill a hole all the way through the tibia," said Adickes. "In this technique you actually see the drill bit inside the joint and then drill pulling backwards so that the tibial cortex is never breached. Since the hole in the tibia is not complete, there is less damage to the soft tissue on the medial side of the knee."
The graft is pulled into the femoral tunnel through the medial arthroscopy portal and the RetroButton tool is deployed. To hold the graft in place, a bioabsorbable screw is inserted into the femoral drill. A second screw is then inserted into the tibia to hold that part of the reconstruction in place. A suture button is then placed on the tibial cortex allowing double fixation to the new ACL on both ends of the graft. A diagnostic tool called the Lachman test is then performed to ensure excellent tension of the graft.
Serving as online moderators during the live Webcast will be Tim Hoover, Arthrex education coordinator, and Brad Cooper, certified athletic trainer at Memorial Hermann. The moderators will receive e-mailed questions from viewers worldwide and relay them to Adickes, who will answer selected, appropriate inquiries during the surgery. The Webcast will be available for online viewing for at least one year, and Adickes will continue to receive and answer e-mailed questions for one week following the surgery.
The program is the 14th in a series sponsored by Memorial Hermann Health System, giving medical professionals and consumers the opportunity to view leading-edge surgical procedures live on the Internet from anywhere in the world.