A Prime Technique for ACL Reconstruction | Dr. Dan Johnson

Whether you’re an athlete or a sports fan, an ACL tear is a big upset—it means you’re benched for the season and usually bound for surgery. Dr. Dan Johnson is Ogden Clinic’s newest Orthopedic Surgeon. One of his clinical interests is reconstructing knees with a quad tendon autograft. Learn why this is a preferred technique for ACL ruptures.

About the ACL

The ACL (anterior cruciate ligament) is one of four major ligaments in the knee. Its #1 job is rotational support. Most of the time, ACL tears are caused when the foot is planted and quickly changes direction, which is why it’s common in sports like soccer, pickleball, volleyball, and basketball.

The injury affects kids and adults, men and women alike. Women and girls are slightly more prone to ACL injury due to the structure of their knee joint and generally having more looseness and more range of motion in the knee than males.

Reconstruction Options: Autograft or Allograft

There are two ways that surgeons can reconstruct the ACL using tissue: from either the athlete's own knee, which is called an autograft, or using tissue from a donor, which is called an allograft.

Graft Options: Hamstring, Patella Tendon, or Quad

The two most common graft options use either the hamstring tendons or a part of the patella (knee) tendon. Another option boasting great outcomes is the quadriceps (quad) tendon autograft. Here are a few reasons why Dr. Johnson likes to harvest from the quadricep.

• It’s one of the strongest grafts. Because the quad tendon is so strong, it leaves behind a stronger tendon area that helps patients return to activity quicker. It also has more collagen, fibroblast, and tissue for the surgeon to work with.
• The incision is small and the surgery is minimally invasive. “Instead of incision in the front of the knee, we use poke holes to perform surgery,” says Dr. Johnson. “This is more appealing cosmetically; patients who like to wear shorts and dresses are happier with this technique.”
• The surgery is a bit less painful and less bloody since the surgeon drills shorter “sockets” rather than long tunnels. Less bone drilling is a big advantage.
• Knees heal up tighter and are less prone to re-rupture. From the outside, it looks like not much has happened, but from the inside it’s very stabilizing. “Some athletic populations will also get an internal brace during surgery,” says Dr. Johnson. “I'll string a strong cord with the graft that relieves the load and protects their knee while it heals.”

Do Patients Recover Faster with a Quad Tendon Autograft?

“There are two parts to that question,” says Dr. Johnson. “For early signs of recovery, yes, we do see patients with more controlled swelling and decreased pain. Their range of motion tends to come back faster than other grafts.”

Still, he notes that we are limited to our body’s own ability to heal and reincorporate the graft. “I don’t want patients returning to sport for six to 12 months after any graft surgery—we want the knee strong and fully recovered.”

Should you need ACL surgery, Dr. Johnson will ensure that you have prehabilitation and rehabilitation planned out with a physical therapist. Prehabilitation helps you strengthen the knee before surgery, while physical therapy restores function, range of motion, and strength properly.

Why did you choose Orthopedics?

“I had a friend in high school whose dad was an orthopedic surgeon and became my mentor,” says Dr. Johnson. “I love that orthopedics has fixable problems—they're mechanical in nature.” He adds, “It’s fulfilling that we can get people back to their activities with the same limb function they had before.”

Dr. Dan Johnson is an Orthopedic Surgeon practicing in Logan and Brigham City Utah. Learn more about him or schedule an assessment here.