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Overview of ACL Reconstruction Surgery
What is ACL Reconstruction Surgery
ACL reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, which is located in the knee, to restore its function after an injuryThe torn ligament is removed before graft insertion in an arthroscopic procedure.ACL is crucial for knee stability, especially in weaving or kicking activities.
A ruptured ACL causes knee instability and potential further damage.Most ACL injuries happen during sports and fitness activities that can put stress on the knee:
- Suddenly slowing down and changing direction (cutting)
- Landing from a jump incorrectly
- Pivoting with your foot firmly planted
- Receiving a direct blow to the knee
- Stopping suddenly
A course of physical therapy may successfully treat a knee ACL injury in relatively inactive individuals who engage in moderate exercise and recreational activities or play sports that put less stress on the knees. Most people will have general anesthesia right before surgery.
This helps you to remain asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this ACL surgery.
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Get A Second OpinionACL reconstruction surgery steps
Extra-Articular Reconstruction
During the 1970s and 1980s, the extra-articular procedure was commonly performed for anterior tibial subluxation to eliminate any pivot shift. However, it has lost favor due to residual instability and the later development of degenerative changes. It has been used in isolation or to augment an intra-articular reconstruction.
Intra-Articular Reconstruction
- Preferred choice but does not fully restore knee kinematics, creating a static restraint.
- Involves connecting the lateral femoral epicondyle to Gerdy's tubercle with a collagenous restraint parallel to the ACL.
- Avoids the problem of insufficient blood supply to intra-articular reconstructions.
- Uses the iliotibial band or tract for connecting the lateral femoral epicondyle to Gerdy's tubercle.
- The optimal attachment point for extra-articular reconstructions is the Gerdy tubercle.
- Primarily used with intra-articular reconstruction for severe anterior instability due to injury or stretching of secondary stabilizing structures.
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Book an AppointmentSymptoms of ACL Reconstruction
You might have injured your anterior cruciate ligament if you experience the following:
- Hearing a loud "pop" in the knee and experiencing severe pain afterwards.
- Pain and swelling
- Difficulty walking
- Loss of full range of movement
- Difficulty straightening the knee
An ACL tear is one of the most common knee injuries, especially among people who Participate in high-impact sports like:
- Basketball
- Football
- Soccer
- Skiing
- Hockey
Choosing Tissue For ACL Surgery
The tissue to replace your damaged ACL will be collected from your body or a donor. The tissue collected from your own body is called an Autograft. The two most common places to take tissue from are the kneecap tendon and the hamstring tendon. The hamstring is the muscle behind the knee. The tissue taken from the donor is called an Allograft.
The Procedure of ACL Surgery
The procedure is typically done using knee arthroscopy. A small incision is made in the front of the knee for an arthroscope, which has a fiber-optic camera and surgical tools. This lets the surgeon see inside the knee via a video monitor, allowing them to check the ligaments and other tissues.
The surgeon will remove the torn ACL and clean the area. They will drill small holes in the tibia and femur to attach bone plugs with posts, screws, staples, or washers. Any other damage will be fixed, and then the ACL will be replaced by following steps:
- The torn ligament will be removed with a shaver or other instruments.
- Tissue is being used to make the new ACL, and then the surgeon will make a more significant cut. The autograft is removed through this cut.
- The surgeon will attach the new ligament to the bone with the screws or to the other devices to hold it in place.
At the end of the surgery, the surgeon will close the cuts with the sutures (stitches) and cover the area with a dressing. You may be able to view pictures after the procedure of what the doctor saw and what was done during the surgery.
Risks Involved in ACL Surgery
All surgeries have a particular risk, such as:
- Pain
- Bleeding
- Infection in the surgical wound
- Unsightly scarring
- Blood clots
- Difficulty passing urine
There is a possibility of getting an allergic reaction to the tracer. People who are highly allergic to iodine, aspartame and saccharin need to talk to their doctor. Some of the health conditions include:
- Break of the kneecap
- Damage to nerves around the knee
- Infection in the knee joint
- Discomfort in the front of the knee
- Loss of knee movement
- Recurrent giving way of the knee
- Severe pain, stiffness, and loss of use of the knee (Complex Regional Pain Syndrome)
Prognosis
Most people might have a stable knee that will not give away after the ACL reconstruction. Better surgical methods and rehabilitation have led to the following:
- Less pain and stiffness after surgery
- Fewer complications with the surgery itself
- Faster recovery time.
Frequently Asked Questions
ACL surgery is a major surgery that reconstructs or replaces a torn anterior cruciate ligament (ACL) in your knee. Your doctor may only consider ACL surgery for you if it suits your needs and lifestyle.
Patients walk unassisted within 2-4 weeks, but for short periods. After 10-12 weeks, expect brisk walking, light jogging, and even plyometric exercise. Full recovery on ACL reconstruction is 6-12 months or more with physical therapy.
An average recovery takes about six months, but it can take longer. If you are an athlete, your doctor may recommend a sports-specific rehab program.
ACL surgery can fail, even in the best of circumstances. It is generally felt that a well-done ACL reconstruction has about a 5% chance of failure due to trauma. The most common cause of an ACL graft failure is a technical error with malposition of the original ACL reconstruction tunnels.
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