ACL Reconstruction in 2020
By Dr Price Gallie
No other letters strike fear into a sportsman following a knee injury like 'ACL', but an innovative technique by a Gold Coast Private lower limb surgeon is helping change that. Dr Price Gallie offers an “all-inside” arthroscopic ACL reconstruction using a shorter graft with a wider diameter that allows an accelerated recovery and may reduce the risk of re-rupture.
Dr Gallie also uses a variety of grafts including the patellar tendon, quadriceps tendon and allograft (donor tendon), alongside the traditionally-used hamstring - matching the graft to the patient, rather than the other way around.
He said with advanced surgical techniques and training programs to help prevent ACL tears, the injury need-not be feared like it once was.
“Historically, rupture of the anterior cruciate ligament (ACL) was a devastating, career-ending injury for athletes and sportsmen with poor diagnosis, limited surgical options and a painful and lengthy recovery process,” said Dr Gallie.
“Preventative measures of developing appropriate muscle strength and encouraging safe movement patterns means we can significantly reduce the number of ligament tears - which has been particularly relevant in the vulnerable teenage group.
“We have also seen a significant improvement in the detection of ACL tears which has come about through better knowledge and education, as well as easy access to MRI scans in the setting of acute knee injuries.”
Dr Gallie said while preventative programs could lessen the severity of the injury, surgical technique played the most important role in the success or failure of ACL reconstructive surgery.
“With ACL reconstruction, we aim to restore normal movement and function, which is why I pioneered the introduction of the “all-inside” technique using the TLS® system,” he said.
“The system facilitates precise placement of the graft, and with robust fixation, it also allows us to implant a thicker, stronger, and more rigid graft.”
Traditional ACL reconstructions use two hamstring tendons; while the short graft TLS® technique uses only one hamstring and wraps it four times to create a shorter, larger diameter graft.
It is then fixed in place inside the bone with a screw-tape interface which is up to three-times stronger than traditional fixation methods.
“The larger graft diameter has been shown in studies to reduce the chance of re-rupturing the graft in the future,” said Dr Gallie.
“The robust fixation also allows us to have an accelerated early rehabilitation recovery, so patients can now walk independently within hours of the surgery, avoiding splints and crutches.”
More recently Dr Gallie has focussed on other graft choices and is currently studying the use of the peroneus longus tendon with very promising outcomes. “We need to treat each patient on an individual basis rather than doing the same generic operation for everyone,” he said.
“Our goal is not only to return to previous level of sporting activity and performance, but also prevent reinjury in the longer term.”
For more information contact:
Dr Price Gallie
Coast Orthopaedics Pacific Private Clinic
123 Nerang Street, Southport
P: (07) 5591 3454