Dr. Matava describes how a surgeon reconnects a woman's anterior cruciate ligament (ACL) to bone and shares the screw size used during this procedure.
Well, the most common way it’s done is to drill a hole in the tibia, or the shin bone, and another hole in the femur, otherwise known as the thigh bone. You pass the graft up in an arthroscopic fashion and then you hold the bone in place with screws.
Now that the most common screws that are available are called interference screws and what they look like are two little bullets, about an inch long that have threads throughout that go between the bone tunnel and the bone graft. It wedges in place and holds the graft there until the graft heals.
After about eight weeks or so, you really don’t need the screws any longer because the bone is healed to the graft and the screws are just there. Some other methods of doing the surgery where you actually hold it involve, where you put a screw or a washer into the bone and then you loop the graft over that. Again, it’s another very good option, but a different way to skin the cat, so to speak, and a lot of these depend upon what type of graft you use.
The most common graft, as I mentioned, is a bone patellar tendon bone graft, but a hamstring graft is often very useful in women, in particularly in older age women because it tends not to hurt as much. It tends to leave a smaller scar and that is fixed a little bit differently.
The typical screw is about an inch long by about 10 mm wide.
About Dr. Matava, M.D.:
Dr. Matthew J. Matava, M.D., is an associate professor and orthopedic surgeon at Washington University School of Medicine in St. Louis. Specializing in sports medicine, his clinical areas of interest include ligament injuries of the knee, athletic injuries of the shoulder and elbow, and pediatric orthopedic knee disorders.