Anterior Cruciate Ligament (ACL) Reconstruction

Anterior cruciate ligament (ACL) reconstruction refers to the replacement of the damaged ACL with a tissue to facilitate normal functioning of the knee. ACL is a major stabilizing ligament in the knee, which connects the femur to the tibia. ACL helps provide proper movement of the tibia. ACL also facilitates pivoting or sudden change in the direction of the leg, preventing the damage to the knee.

Damage to the ACL Surgery 

The ACL can be injured in different ways, thus warranting a need for ACL repair. The following scenarios may damage the ACL:

• Collision with a football
• Slowing down while running
• Landing incorrectly after a jump
• Twisting of the knee and the foot in opposite direction

Initial Treatment for Anterior Cruciate Ligament Tear

The ACL may not require surgery when the knee is stable when the ligament is not torn completely, or even when you don’t have to strain your knees by active sports. The alternate treatment in such a situation is “RICE” – Rest, Ice, Compression, and Elevation.

Physiotherapy, exercise, and braces for legs can help provide support to the knee. Exercises such as swimming, running in a straight line, and playing golf can be preferred by active individuals if they do not wish to return to an active sports life.

General anaesthesia or local anaesthesia will be given before ACL reconstruction surgery. The tissue to replace the damaged ACL will be taken from the kneecap or hamstring tendons of your body, or from a donor. The surgery is usually performed with the help of knee arthroscopy.

ACL repair involves the use of a camera inserted into the slit made in the knee. A computer connected to the camera facilitates viewing of the inner ligament, by which the physician can perform the surgery. Other incisions are made to incorporate the required equipment and then the ACL reconstruction surgery is performed.

• The torn ligament is removed with the shaver.
• If the patient’s tissue is used, the surgeon would make a larger cut and remove the tissue.
• The knee bone is drilled and the tendon is now implanted into the position where the old ACL was present.
• Screws and other instruments are used to attach the new tendon to the bone.
• The bone tunnels would gradually fill in as the bone grows, which holds the ligament in place.
• Small incisions made in the area of the surgery are closed with sutures and sterile dressing.

You will be sent home on the same day of the surgery. You will be instructed to use knee braces or crutches after one to four weeks of the surgery. The physician prescribes pain medications if required. Physiotherapy could help retain the integrity of the knee faster.

• It may take a minimum of 6 months for any individual to recover after the surgery, depending on the individual’s rate of recovery.
• If pain and swelling are observed, an ice pack can be applied over the area. But there should be no direct contact between the ice with the skin as it can cause damage to the skin.
• You should follow the physician’s recommendations to recover soon and without any complications.
• People who have a desk job can return to their duties in a week’s time and people involved in active exercises or who are athletes should avoid returning to their work for a minimum of six months.
• Playing sports such as basketball after the surgery might not be possible and physician’s advice is recommended. 
  
  

Pros

• Fast recovery
• Pain relief
• Normal working of the knee
• Returns stability of the knee

 Cons

• Blood clot in the legs
• Weakening of the knee
• Failure of relief from pain
• Stiffness in the knee
• Limited movement of the knee
• Tear in the newly transplanted tendon