New kind of knee surgery provides much needed relief for patients

A new kind of knee surgery is providing much needed relief for patients in the greater Houston area. For many years, anterior cruciate ligament (ACL) reconstructions have been frequently performed to correct instability in the knee, however many patients never return to their pre-injury level of activity following surgery. That is changing, says orthopaedic surgeon Dr. William Hayes, because surgeons are now addressing injuries to the anterolateral ligament (ALL) in the knee as well. Trained specifically in sports medicine, Dr. Hayes is currently the only surgeon in the Houston area performing ALL reconstruction.

"I've performed approximately 30 ALL reconstructions since late last year, and I'm very pleased with the surgical outcomes," says Dr. Hayes with Sterling Ridge Orthopaedics & Sports Medicine. "The stability it gives the patient is really exciting." These surgeries have all taken place at Lake Woodlands Surgical and Spring Central Hospital.

The ALL procedure was pioneered in 2013 after Belgian surgeon Dr. Steven Claes published a study showing the ALL is present in 99 percent of knees. "Doctors have known about the possible existence of this ligament, but now we're putting the whole puzzle together," says Dr. Hayes, "and that means better care for our patients." By repairing this ligament, doctors can correct pivot shift, or episodes where the knee gives way during activity.

"With ACL surgery in past, the knee may still have a little bit of laxity, so people can't always get back to doing what they want to do. With ALL, if you put the graft in the right spot, you're not going to hinder their motion. We're giving them a solid knee, so they can get back to even high impact sports like snow skiing. I'm giving them what they had before."

Dr. Hayes uses an exam under anesthesia to diagnose an ALL injury. While not all patients with an ACL tear require a simultaneous ALL reconstruction, he is ready to reconstruct both ligaments if needed. And since both diagnosis and repair can happen during the same procedure, the patient doesn't have to undergo surgery twice.

"Orthopedic surgeons in general have undertreated people with ACL tears because we have missed this injury," says Dr. Hayes. "This procedure allows us to just back up a second and help those people who were missed in the past. Our patients are very happy with it, and that's what it's all about."

While not everyone with knee problems could benefit from this surgery, the patients who have undergone it have been very happy with it. The procedure only requires two small incisions, which means scarring is minimal, and rehabilitation is basically the same as with ACL surgery, though it can take a few additional weeks in some cases. Lake Woodlands Surgical follows patients for six months after surgery, and there haven't been any diminished results in comparison with traditional ACL surgery.