r/Sportsinjuriesindia

Uploading a short intraoperative clip from today’s ACL reconstruction.
What you’re seeing is a bioabsorbable interference screw being driven in to secure the graft inside the tibial tunnel. This is one of those moments that patients never get to see, and have I decided to share so that it fulfil is your thirst of knowledge.
A few things to note.
A] The screw is bioabsorbable, meaning it gradually dissolves and is replaced by bone over 12–18 months

B] Proper screw placement is critical , too proud or too deep and you risk graft impingement or poor fixation strength

C] The tactile feedback as it seats flush is something you learn to trust over hundreds of cases

For those post-op and curious: This tiny screw is doing a lot of the heavy lifting in your early rehab weeks while the graft is still integrating.

Respect the timeline we as surgeons give u ..
Happy to answer questions .

One of the most important lessons in knee surgery: if the alignment is wrong, your ACL graft will fail.

She came to us with a painful, unstable left knee.
The diagnosis? A combination that’s more common than people realize — genu valgum (knock knee deformity) with a ACL tear.

This put me into a dilemma of what should I do the deformity or the ligament because both are related to each other

The problem with just doing ACL reconstruction In a knock knee, the mechanical axis passes lateral to the knee centre. This means every time the patient walks, runs, or lands from a jump, the forces on that ACL graft are skewed. Studies consistently show that uncorrected valgus malalignment dramatically increases graft failure rates. You’re essentially rebuilding a rope and then hanging it at the wrong angle.

The plan: staged correction
We performed a Distal Femoral Osteotomy (DFO) — a lateral closing wedge — to correct the valgus deformity, fixed with a distal femoral locking plate. Simultaneously, ACL reconstruction was completed. The alignment is now corrected. The graft has a fighting chance.
Key takeaways for anyone reading this:

Alignment always trumps ligament reconstruction. Fix the bone first, or alongside.
Young active patients with valgus + ACL tears are not straightforward ACL cases.
Skipping the osteotomy is a shortcut to revision surgery.

She is now 7 weeks post-op, full weight bearing, and starting rehab. 💪

happy to discuss DFO indications, the combined vs staged approach debate, and rehab timelines.​​​​​​​​​​​​​​​​