Total Knee Reconstruction

What is a Total Knee Reconstruction?

You’ve probably heard this term from some sports commentator. They are probably talking about a player having knee surgery for a torn ligament. The most common such surgery is an Anterior Cruciate Ligament (ACL) reconstruction. This is quite straight-forward surgery nowadays, using some tendon around the knee to make a new ACL, when the original has been torn. It certainly is not a “total” reconstruction, as it is just one ligament, albeit the most important one for footballers. 

The surgery might be straight-forward, but the impact on an elite player’s career can be profound, as it usually takes a year to get back to playing again at the top level. Some, especially older players, never make it back to that level. Others try to get back sooner, but run an increased risk of the ligament tearing again if it hasn’t had time to mature and strengthen enough. 

This might be where a synthetic ligament like the LARS ligament could be an appropriate medium term solution. Certainly players like Nick Malceski and David Rodan can get back safely in less than 4 months, as opposed to the usual 12 months after the usual reconstruction using a graft from one of their own tendons. The problem is that the device is still experimental, with no known results past 2 years. And in the past, all synthetic ligaments in athletes have tended to start failing after 2-3 years. But even if we assume that that will happen with the LARS, It may still be worth it for a player who needs to get back quickly, maybe for the Olympics, or maybe because to take a year out would end their career.

The “Total Knee” part of the term comes from confusion in terminology between an ACL Reconstruction, and a Total Knee Replacement, which is a completely different thing altogether. Now we are talking about an operation for older people whose knees are worn out with arthritis. Again, there are misconceptions, however, because the operation is not a replacement in the sense of cutting out the whole knee joint and putting some bionic joint. Rather, the worn out surfaces within the joint are chamfered off and new metal and plastic surfaces are inserted to allow the joint to run smoothly and without pain.