Top rated orthopedic surgeon in Chicago applies latest techniques to ease the pain, recovery of ACL reconstruction

By Nick Rees

The anterior cruciate ligament, which stabilizes the knee and minimizes stress across the knee, can be torn by a sudden stop or twisting motion of the knee or by a blow to the front of the knee.

"The most consistently torn ligament in the knee is the anterior cruciate ligament," explains Dr. Mark Gross, a top rated orthopaedic surgeon in Chicago. "The ACL is being torn more in women than it used to be because they're playing more sports and playing them more aggressively.

"We now have techniques for reconstruction of the ACL and the posterior cruciate ligament that can be done minimally invasively."

One means of repairing a torn ACL is to utilize an allograft, which is a ligament taken from a cadaver.

"Allografts are becoming more popular," Dr. Gross says. "We now have tissues we can use to reconstruct ligaments. This means we don' have to get a ligament from patients themselves."

"Cadaver grafts are very good," Dr. Gross says. "We use companies that are the gold standard nationally for our grafts. They're very predictable, very liable and definitely stand the test of time as far as being the safest source of allografts."

ACL reconstruction, Dr. Gross says, has become an outpatient procedures with people walking on the injured knee quickly. No bracing or casting is required and the pain is less than a more invasive procedure.

"Patients begin walking fairly rapidly, usually within 10 to 14 days, with minimum pain medicines," Dr. Gross says. "For getting back to activity, the graft has to heal and mature. That can take anywhere from six months to a year."

For an allograft, Dr. Gross first performs a diagnostic arthroscopy to look under a patient's knee cap at the joint's surfaces, the joints themselves and the ligaments to see what damage exists.

"We might repair a meniscus or remove a cartilage fragment," Dr. Gross says. "Then we do the ACL reconstruction. We make an approximately 1.5 centimeter incision down the leg and drill through the bone of the tibia up into the femur and clean that up. We then figure out what size cadaver graft we need from our deep freeze implant storage based on the patient's unique measurement to fit the patient.

"The graft is then pulled through the tibia up into the knee and into the femur. We fix the femoral side with pins to hold the graft in place. On the tibia side, we use a screw to hold it in that position. Because the fixation is so good, we can move it right away."

The best outcomes for ACL reconstruction are achieved by surgeons who place the graft correctly, Dr. Gross says.

"Surgeons that put the graft where it's supposed to go in a reliable way get the best results," Dr. Gross says. "Putting the graft in correctly means that patients can return to activities within a reasonable fashion. A lot of people will advertise what they do, but the proof is in delivering what you say you will and giving patients the results they want and the long term outcomes they want."

Dr. Mark Gross was selected in 2010 by TopTierMD as a Chicago Top Doctor - He was named a Best Chicago Orthopaedic Surgery specializing in Minimally Invasive Hip and Knee Joint Replacement, Minimally Invasive Unicondylar Knee Arthroplasty, and Patellofemoral Knee Arthroplasty.  He practices in Barrington Office, IL