Failed Anterior Cruciate Ligament (ACL) Reconstruction

What is a TLS Short Graft ACL Reconstruction?

The TLS short graft ACL reconstruction is an advanced surgical technique performed to repair a torn ACL ligament in the knee. It involves the use of a tape locking screw (TLS) system that enhances the strength and mobility of the reconstructed ACL tendon, allowing the return to sports or an active lifestyle. 

Benefits of TLS Short Graft ACL Reconstruction

The benefits of the TLS short graft ACL reconstruction include:
Single tendon harvest: With the TLS short graft ACL reconstruction, a single hamstring tendon is harvested; thereby, reducing pain and discomfort at the harvest site. Traditional ACL reconstruction involves the use of 2 hamstring tendons to create the graft.
Thicker graft diameter: The harvested hamstring tendon is quadrupled over itself to create a short, thick and very strong graft. With traditional ACL reconstruction, the graft is thinner and more likely to re-rupture.
Firm fixation: The innovative tape locking screw system provides most of the strength while the newly placed graft heals and firmly attaches itself to the bone.
Less pain: There are less bone and tendon trauma resulting in reduced pain associated with the TLS short graft ACL reconstruction as gentle hand-reamers are used for part of the surgery instead of motorized drills and only a single hamstring tendon is used.
Faster recovery: Better fixation and strength of the graft results in early mobility and participation in physical therapy rehabilitation.
Faster healing: Hand reaming of the sockets for the ACL graft inside the knee and passing the graft from the inside out allows for a tight fit and stable bone-graft contact. This improves the potential for faster healing.

Preparation for TLS Short Graft ACL Reconstruction

Prior to TLS short graft ACL reconstruction surgery, you should have a preoperative appointment with a physiotherapist to be fitted for crutches. You will be instructed to bring these crutches with you on the day of the surgery. You will also be instructed on how to safely use the crutches and the exercises to be performed after the surgery.

TLS Short Graft ACL Reconstruction Procedure

During the procedure, holes are drilled into your shinbone (tibia) and thighbone (femur), and the harvested tendon graft is inserted through these holes. Gentle hand reamers and tape locking screws are used during the procedure to ensure precise placement and adequate strength of the ACL graft. 

What to expect after TLS Short Graft ACL Reconstruction

You will receive intravenous pain medication and antibiotics immediately after the procedure. Most patients can return home after an overnight stay in the hospital. However, you may be allowed to return home on the very same day if your postoperative discomfort and swelling is well controlled.

A physiotherapist from the hospital will evaluate you prior to discharge and take you through a list of simple exercises that you should perform after the surgery. These include isometric knee extension, heel slides, chair-assisted squats and calf raises. 

You will be provided pain-relieving and anti-inflammatory medication to help control symptoms. Regular use of an ice compression brace will further help reduce swelling and improve knee mobility. 

TLS Short Graft ACL Reconstruction Follow-Up Care

A 2-week follow-up visit will be scheduled with your doctor to assess your progress after surgery.

Recovery after TLS Short Graft ACL Reconstruction

The strength of the TLS short graft ACL reconstruction allows early mobility and participation in physical therapy rehabilitation. Crutches are usually required for the first 2 weeks after the surgery. You should be able to return to light activities within a week. Heavy lifting, prolonged standing, stair climbing or bending are not advised for at least 4 to 6 weeks. By 6 months, you can expect to return to sports.

Risks Associated with TLS Short Graft ACL Reconstruction

The TLS short graft ACL reconstruction is a very safe procedure; however, as with any surgical procedure, there is a minimal risk of stiffness and infection of the knee, as well as re-rupture of the graft.

Prognosis of TLS Short Graft ACL Reconstruction

The prognosis of TLS short graft ACL reconstruction is good, with most patients experiencing a positive outcome.