Cruciate Ligament Reconstruction "Advanced ACL Repair"
Dr. Weninger, you specialize in knee injuries, including repairing torn cruciate ligaments. When does a torn cruciate ligament need surgery?
The anterior cruciate ligament is an important anatomical structure to allow for normal knee function. If a cruciate ligament tear occurs, the knee becomes unstable and gives way. This can happen in sports as well as in everyday life. The reconstruction of the anterior cruciate ligament always makes sense to restore the stability of the knee joint. Restoring the stability of the knee joint is particularly important in sports with rotating movements and stop-and-go. But I also recommend reconstruction of the cruciate ligament if there is instability in everyday life.
How soon after an accident does a torn cruciate ligament have to be operated on?
It is now known from the current literature that the reconstruction of the anterior cruciate ligament should be carried out as early as possible after the injury. This is very important to prevent secondary damage due to instability. In selected cases, the patient's own ligament can also be preserved if the operation is carried out early. It is best when the knee is no longer swollen and mobile, but this does not necessarily have to be the case.
How does this method work, and what are the advantages of it?
The aim of the Advanced ACL Repair method is to get professional and amateur athletes with cruciate ligament injuries back into active sports as quickly as possible.
I published the operational strategy "Advanced ACL Repair" in an international journal in 2020. The aim is to bring both amateur and top athletes back to sport as quickly as possible after a cruciate ligament tear, but above all as safely as possible. The aim is to avoid any subsequent injury.
First of all, our surgical procedures are standardized in such a way that the operation never lasts longer than 30 minutes. This has immense advantages for my patients, since the infection rates correlate linearly with the duration of the operation. This means: the longer an operation lasts, the higher the risk of infection. The consumption of anesthetics can also be reduced by short operating times.
I operate on my patients in such a way that the reconstructed, "new anterior cruciate ligament" becomes stronger than their own cruciate ligament. The so-called FiberTape plays a decisive role in this. This is a reinforcement material to make the new cruciate ligament even more biomechanically stable. I don't use a tourniquet in surgery. This reduces the risk of vascular or nerve injuries. I also use a highly effective antibiotic that is also placed in the knee joint. This reduces the risk of bacterial infection to zero! I also completely refrain from so-called Redon drainage (secretion hose) so that the mucous membrane is not irritated after the operation.
My patients are allowed to put full weight on their knee and move it freely right after the operation. This immediately activates and strengthens the musculature, and counteracts muscle atrophy. We routinely use the Game-Ready decongestant cold compression to reduce swelling.
The shock wave is also used routinely to improve blood flow to the reconstructed cruciate ligament so that it can grow into the knee more quickly. “Advanced ACL Repair” has one goal: increasing patient safety!
For which cases is the Advanced ACL Repair method suitable?
The strategy is suitable for all patients, regardless of whether they are professional or hobby athletes. Every amateur athlete also benefits from this method, which is routinely used by professional athletes. So far, I have successfully operated on more than 1000 patients with "Advanced ACL Repair". Of these, not a single patient suffered a repeated injury to the cruciate ligament.
If, in addition to the cruciate ligament rupture, there are further injuries of the knee - e.g. of the meniscus - are these also treated at the same time?
I follow the “One-Stop-Shop” principle. This means all associated injuries are treated in the same and single operation. Of course, this has the huge advantage that only one operation with only one anesthesia and hospital stay are necessary. It is also known that sewn meniscus tears, for example, heal much better if the anterior cruciate ligament is reconstructed at the same time.
In your experience, what is the success rate of this surgical method?
So far, we have operated on 1134 patients using the method "Advanced ACL Repair". These have been and are being checked regularly. The results so far have been extremely satisfactory. In concrete terms: not a single infection, significantly less pain after the operation, significantly less muscle atrophy, extremely rapid mobilization, free mobility was regained quickly.
What should be considered after the operation and how long does the rehabilitation last?
The most important thing after the operation is to move the operated knee immediately and as freely as possible. Decongesting lymphatic drainage begins immediately after the surgery and in principle immediate full joint loading is permitted and makes sense. We also start physiotherapy immediately after the operation. After about 2 weeks, my patients can use the ergometer, easy walking is possible after about 6-8 weeks. For stop-and-go sports, I recommend to wait at least 8 months. In any case, until the muscles on the left and right are equally developed. In addition, we monitor the healing using MRI and recently also the circulation of the new ligament using color Doppler ultrasound - a very innovative procedure.
What are the advantages of treatment in the Döbling Private Hospital?
The hospital and I follow the same principles:
Patient safety is the top priority!
In principle, I only operate where I would operate my family and would chose to be operated myself. I am very quality-oriented and have high quality standards for myself and my working environment. The Döbling Private Hospital offers my patients, as well as me, optimal conditions. It starts when my patients are admitted to the hospital. The friendliness of the staff is unique, as is the competence of the doctors and nurses. Everything is available to my patients in the hospital: the best equipment, the latest technology, excellent staff, 24-hour monitoring. In the operation theatre itself, the highest quality standards ensure smooth and relaxed processes - a dream for every surgeon with a large number of cases!
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