ACL (Anterior Cruciate Ligament) Reconstruction
What is ACL (Anterior Cruciate Ligament) Reconstruction?
The ACL, or the Anterior Cruciate Ligament, is a crucial part of the knee, important for stability and movement. This ligament maintains the connection between the femur (the thigh bone) and the tibia (the leg bone). The ACL ensures that the femur and tibia move as they should and allows for changes of movement without the knee collapsing.
How does the ACL get injured?
Many people know of ACL injuries through sporting injuries. Injuring the ACL involves a tear occurring in one of the ligaments that connects the femur and the tibia. The ACL is prone to tearing through movements that involve the knee bending side to side, backward or even twisted. If more than one of these movements occurs, the risk of injury is much higher.
An ACL tear can result in pain in the knee, as well as swelling and weakness. Sometimes rest and rehabilitation exercises can help, but surgery is often required to prevent a long-term knee problem.
The severity of an ACL tear can vary from minor (a small tear) to severe, where the ligament might tear entirely. The ligament, along with part of the bone, can also separate from the rest of the femur or tibia in the most serious cases.
For these injuries, ACL reconstruction surgery is absolutely necessary.
ACL (Anterior Cruciate Ligament) Reconstruction Surgery
Pre-Operation: How to prepare for ACL Reconstruction
Preparing for an ACL reconstruction will involve additional scans to accurately assess the joint. These scans will allow Dr Daniel Rahme to determine the damage to the other ligaments and cartilage around your knee. In turn, that means Dr Rahme will be able to plan your procedure and rehabilitation with more accuracy.
Surgery: What to expect?On the day of your anterior cruciate ligament reconstruction, you will be admitted to hospital. You will meet your anaesthetist before surgery and they will explain the anaesthetic that will be used, as well as medications for pain relief post-operation.
You’ll receive your anaesthetic, and antibiotics which are administered by IV drip. A torniquet will be placed above your knee to help reduce blood flow during the procedure, and sterile drapes will cover your knee.
The procedure involves removing tendons from your hamstring, through an incision at the front of your knee. Occasionally, kneecap ligaments or hamstring tendons from your other leg may be required.
Using an arthroscope, Dr Rahme will survey your knee joint for any additional damage, which will be treated throughout the same surgery. Then, a hole is drilled in the tibia and the femur, allowing them to be reconnected with the hamstring tendons, as the anterior cruciate ligament would. These tendons will then be held in place with screws and buttons.
A local anaesthetic will then be injected into your knee to lessen pain post-operation. Incisions will be closed with sutures, and your knee placed in a dressing. Once you’ve left the theatre, you will be closely monitored in the recovery ward. Then, will be taken to your ward where you will wake fully.
A physiotherapist will also visit you to discuss rehabilitation plans and exercises. Most patients can be discharged on the same day as their surgery.
Risks and Complications
As with most surgeries, there are some risks and complications that may occur with ACL reconstruction. These risks may include infection, blood clots or bleeding. However, these complications are rare, and Dr Rahme will discuss these with you.
ACL Reconstruction Recovery and Timeline
Recovering from an ACL injury and the subsequent ACL reconstruction can take some time. While you may be able to weight bear right away, you won’t be able to return to sports for roughly 9-12 months. You can resume office work in 7-10 days, while it will likely take longer to return to manual work. This will have to be managed with your physiotherapist.