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Anterior Cruciate Ligament


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Anterior Cruciate Ligament


Located in the middle of the knee, the anterior cruciate ligament joins the inner posterior part of the external femoral condyle to the anterior inter-condyle region of the tibia. The anterior cruciate ligament impedes the displacement of the tibia in relation to the femur, and allows the correct rotation of the knee.

Injuries to this ligament consist in excessive stretching or torsion which lead to its partial or complete rupture.


Injury to the anterior cruciate ligament can be caused by traumas to the sides of the knee by over-stretching, or after frequent abrupt turns and stops in sports like football, basketball and skiing.


The main symptoms are a crunching sensation at the moment of injury, along with inflammation, pain, and a feeling of instability in the knee. This feeling can disappear over time, but reappears on going back to the activities that imply “turns” or episodes of torsion in the knee.


Conservative treatment in patients with low functional demand:

  • Ice during early stages.
  • Rest from sport initially, and later, once the severe phase has passed, doing “risk-free” activities and sports like walking, cycling, walking, and in general those that don’t imply turns in the knee.
  • Rehabilitation and strengthening of the thigh muscle.
  • Pharmaceutical therapy using analgesics and anti-inflammatory medication during the acute phase.

In cases of rupture with instability, surgery will be necessary. Otherwise, the joint will behave like an eccentric structure, degenerating over time into arthrosis and impeding the practice of sports.

The Arthroscopic Surgery Unit, through its Biological Therapy Unit is a pioneer in the integral application of PRGF®-Endoret® in the anterior cruciate ligament recovery process.

The anterior cruciate ligament and PRGF®-Endoret®

Below are the basic principles for the reconstruction of the anterior cruciate ligament through biological therapy using PRGF®-Endoret®:

  1. Arthroscopic assessment of the joint.
  2. Washing of the joint and chondroplasty.
  3. Obtention of autologous bone grafts of the pes anserinus (goose’s foot) or the kneecap tendon. If allografts are used, these are prepared in advanced.
  4. The bone grafts are injected with PRGF®-Endoret® and bathed in a container with PRGF®-Endoret® until they are implanted.
  5. Tunnelling of the bone where the plasties will be implanted. The extracted pieces of bone on making the tunnel will be bathed in PRGF®-Endoret®. PRGF®-Endoret®will be injected into the bone tunnels prior to the next step, which is explained below.
  6. The plasties are placed in the tunnels and the bone pieces are used to seal the tunnel. The plasties are injected once again with PRGF®-Endoret®. The rest of the joint is also injected intra-articularly.
  7. A precise rehabilitation plan is established for the production of mechanical stimuli which act synergistically with the reconstructive technique and the PRGF®-Endoret®.