Anterior Cruciate Ligament Reconstruction

The History of Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament is one of the four main ligaments of the knee. Its role is to prevent abnormal forward movement of the lower leg relative to the thigh bone.

In case of rupture, the ligament is unable to heal spontaneously, but its function can be restored through ligament reconstruction. With the development of non-invasive examination methods, the predictability of surgery has also greatly improved, and high-resolution, detailed MRI scans are of undeniable importance:

• In identifying concomitant injuries
• In the diagnostics of fractures—not visible on conventional X-rays—without displacement
• In the precise identification of the cartilage covering the joint surface

The advancement of surgical techniques and precise postoperative functional examinations have proven that beyond the choice of graft (a new anterior cruciate ligament formed from a hamstring tendon), its anatomical placement at the origin and insertion points is crucial. Since the 1990s, anterior cruciate ligament reconstruction has been performed in increasing numbers worldwide. Initially, the patellar tendon-bone block – BTB (bone tendon bone) – graft, and nowadays, reconstruction with so-called Hamstring tendons, has become the leading surgical intervention.

Beyond graft selection, the significant differences between surgeries lie in the fixation techniques. The great advantage of the transfixation femoral – i.e., through the thigh bone – fixation technique is the fixation close to the opening of the femoral tunnel, which reduces the movement of the new cruciate ligament within the tunnel, thereby reducing the development of postoperative graft failure due to tunnel widening. Using targeting through the anteromedial portal, the femoral tunnel can be placed at the anatomical origin point. Basic research confirms that the forces acting on grafts placed at the anatomical origin point are similar to those on the original cruciate ligament.

Most common causes of injuries

Anterior cruciate ligament rupture can be caused by:

• Forceful outward rotation, flexion, and lateral displacement of the knee
• Forceful inward rotation, extension, and medial displacement of the knee
• Hyperextension or hyperflexion of the knee

Approximately 70% of anterior cruciate ligament ruptures occur during sports activities:

• Patients most often suffer anterior cruciate ligament ruptures during skiing, basketball, handball, and football.
• The 15-45 age group is most frequently affected. In this age group, the annual incidence rate is 1:1750, which can be considered a very common injury.
• 70% of anterior cruciate ligament ruptures occur through non-contact mechanisms, while the remaining 30% occur during direct contact sports.
• Women suffer anterior cruciate ligament ruptures more frequently than men.

BMM’s Anterior Cruciate Ligament Reconstruction Surgeons

Dr. Péter Doszkocs

My motto: diligence, precision, patient-centered care!

Following family traditions, Dr. Péter Doszkocs developed his manual skills at a technical high school in Szeged, then earned his medical degree from the University of Szeged in 2004. The combination of orthopedics and traumatology is an ideal profession for him, which he practices as both a vocation and a passion.

He gained 12 years of experience in Germany treating accident victims, with a particular focus on hip and knee prostheses. He specialized in Karlsruhe, worked with robotic surgery and navigation techniques for five years, then led the orthopedic department of the Freudenstadt clinic as chief physician. In 2022, he returned to Hungary and continued his work at the Traumatology Clinic of the University of Szeged, where he specialized primarily in the treatment of knee ligament and cartilage injuries.

His work emphasizes detailed diagnostics and collaborative therapy planning with the patient, ensuring the patient fully understands their condition and the recommended intervention. He performs hip replacement surgery using minimally invasive “bikini incision” techniques, preserving gluteal muscle integrity. With modern computer-aided planning and robot-assisted surgeries, he strives for the highest precision.

His services include total and partial knee prosthesis implantation, axis correction, cartilage transplantation, cruciate ligament plasty, arthroscopic interventions, and joint-protective injection treatments (e.g., hyaluronic acid), aiming for rapid rehabilitation and lasting improvement in quality of life.

Dr. János Bartha

A physician should treat their patients as they would treat themselves as a patient, or their beloved parents or children. This encompasses everything from humanity to precise treatment.

My conviction is that healing is not just about the body, but about understanding the whole person. In my work, I strive to achieve genuine, functional recovery for every patient through precise diagnosis and personalized treatment – together.

My curious nature has driven me forward since childhood: even as a child, I questioned stories if I didn’t understand something. The questions “why?” and “how?” have always fascinated me, and this strong inner drive – coupled with my perseverance – continuously deepened my thirst for knowledge. At the age of sixteen, I decided to dedicate this interest, my creativity, and the inner strength within me to healing patients.

I completed my medical studies at the University of Medicine and Pharmacy of Târgu Mureș, where I felt early on that orthopedics and traumatology were my path. This specialty combines continuous creative thinking with good manual dexterity, precision, spatial vision, and quick, decisive decision-making – all in a dynamic environment full of challenging situations where I have always found myself.

I worked in Germany for 13 years, where I performed interventions at a high professional level in both orthopedics and traumatology. In 2018, I obtained my specialist qualification, and then in 2019, I was appointed chief physician. Of this, I spent 11 years in the same hospital, 6 years in a chief physician position.

Dr. Szabolcs Gáspár

Orthopedic-Traumatologist, Head Physician of BMM Department

He primarily deals with hip and knee joint problems, prosthesis surgeries, and treats patients who have suffered musculoskeletal accidents. In addition, he is a professional soldier and university lecturer, and regularly attends national and international conferences for knowledge and experience exchange. His love for the medical profession dates back to his childhood.

“Even in kindergarten, I wanted to be an accident surgeon, my grandmother told me that. For a while, I gave up on it during my medical studies because it seemed like the hardest part, and I thought I’d rather be an orthopedic surgeon. Eventually, fate had it that I became both, and I don’t regret it. These two branches of the medical profession fit together very well. I love to operate, and there’s nothing better than doing what you love.”

For him, teaching is also an important part of his medical career. “I really enjoy teaching; I see the future in training the next generation so there will always be someone to heal. We need to show medical students how to provide good, professional, and interesting care.” Dr. Szabolcs Gáspár implements this in practice based on the following principles:

Dr. Péter Molnár

He is equally at home in accident surgery, which requires immediate assistance, and in the longer-term, planned orthopedic field.

His early connection to orthopedics dates back to his university years when he first encountered the specialty as a patient. Later, even stronger ties bound him to it. “The human skeletal system, orthopedics, is based on physics and statics, which I loved very much,” explains Dr. Péter Molnár. “In my youth, I even considered becoming an engineer, but then, probably following my father’s example, I decided on a medical career. When I experienced the hospital atmosphere in practice, I liked it even more. During high school summers, I worked as a surgical assistant in the hospital where my father practiced. That’s when it became certain that I wanted to work in a practical field, in surgery.“

At the beginning of his career, he also worked with children at the Miskolc Hospital. His attraction to pediatrics remained later on. “The little ones are always very grateful and kind. Many of them can’t even speak yet, but they smile when I examine them. They provide true rejuvenation.”