Anterior Cruciate Ligament (ACL) Reconstruction
Anterior cruciate ligament (ACL) reconstruction is a surgical procedure to repair or replace a damaged ACL, which is one of the major ligaments in the knee. The ACL is responsible for providing stability to the knee joint and preventing excessive forward movement of the tibia bone under the femur bone. ACL reconstruction surgery involves replacing the damaged ligament with a graft, which can be obtained from the patient’s own tissue (autograft) or a donor (allograft). The most common autograft sources are the patellar tendon or the hamstring tendon, while the most common allograft source is the Achilles tendon.
ACL surgery is primarily used to treat a torn or ruptured anterior cruciate ligament (ACL) in the knee joint. ACL injuries often occur during athletic activities or as a result of trauma to the knee joint. Surgery may be recommended for patients who are experiencing significant pain, instability, and difficulty with daily activities due to their ACL injury.
The requirement of surgery is determined by the extent of the ACL tear and the patient’s way of life. A completely torn ACL cannot self-heal, but in some instances where the ACL is partially torn, studies have found that the ligament may recover without surgery. The doctor will perform two manual tests, the Lachman test, in which the physician will try to separate the shin bone from the thigh bone to identify whether the ACL is intact or not, and the Pivot shift test, in which the doctor places rotational pressure on the knee while the patient lies on their back. If the bones do not shift, the test is negative. For patients with a partial tear, surgery may be delayed and the healing process may be observed first without surgery.
Preparation for ACL Reconstruction
The surgeon will provide instructions on how to prepare for the operation, which may include quitting smoking to reduce the risk of infection and slow healing. The procedure is typically done as a day case, with options for general anesthesia, where you will be asleep, or spinal anesthesia, which will numb the lower part of your body but allow you to stay awake. A sedative may be given to help you relax, and you will need to arrange for someone to drive you home and stay with you overnight. The hospital will advise you on when to stop eating and drinking prior to the surgery, and you should ask any questions if you have concerns.
ACL Reconstruction Procedure
The procedure is typically performed arthroscopically, which means that small incisions are made in the knee and a small camera is inserted to visualize the inside of the joint. The surgeon uses specialized instruments to remove the damaged ligament and prepare the bone tunnels for the new graft. The graft is then passed through the bone tunnels and secured to the bone with screws or other fixation devices.
After surgery, patients typically undergo a rehabilitation program that includes physical therapy and exercises to restore strength, flexibility, and range of motion to the knee. Full recovery can take several months, and patients are usually advised to avoid high-impact activities and sports for a period of time to allow the graft to heal properly. With proper care and rehabilitation, ACL reconstruction can help patients regain stability and function in their knee joint. It usually takes six to nine months for a patient to return to participating in sports after an ACL reconstruction, depending on the level of competition and the type of activity. Patients are able to walk with crutches and a leg brace on the day of surgery. Very soon after surgery, the patient enters a rehabilitation program to restore strength, stability and range of motion to the knee.
Benefits of ACL Reconstruction
The benefits of ACL surgery include stabilizing the knee joint and reducing the risk of further knee injuries, as well as improving knee function and reducing pain. Surgery can also help to prevent the development of degenerative joint disease and improve the overall quality of life for the patient. Additionally, undergoing ACL surgery can enable patients to return to physical activities and sports that they may have had to give up due to their knee injury.
