ACL Reconstruction Surgery: Steps, Preparation and Procedure
ACL Reconstruction Surgery is a procedure to replace a torn anterior cruciate ligament (ACL) in the knee. The ACL is a crucial ligament that helps stabilize the knee joint, often damaged due to sports injuries or accidents.
In this surgery, a graft (typically taken from the patient’s own tendon or from a donor) is used to replace the damaged ligament. The surgery is performed arthroscopically, using small incisions and a camera for guidance. The goal is to restore knee stability, allowing the patient to return to physical activities and sports after a period of recovery and rehabilitation.
ACL Reconstruction Surgery Steps
- Anaesthesia: The patient is administered general or spinal anaesthesia for a pain-free procedure.
- Incision and Arthroscopy: Small incisions are made, and an arthroscope (a camera-equipped tool) is inserted to visualize the knee joint.
- Removal of Damaged ACL: The torn ACL is carefully removed using specialized tools.
- Graft Preparation: A graft (usually from the patient's hamstring or patellar tendon) is prepared to replace the damaged ligament.
- Graft Placement: The graft is inserted into the knee and secured using screws or other fixation devices.
- Stitching and Dressing: The incisions are closed with sutures, and a sterile dressing is applied.
- Postoperative Care: The knee is stabilized with a brace, and a recovery plan, including physiotherapy, is initiated.
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Get A Second OpinionPreparing for ACL Reconstruction Surgery
- Consultation with Your Surgeon: Discuss the procedure, risks, and recovery plan in detail. Address all your questions and concerns.
- Medical Evaluation: Undergo required tests, such as X-rays or MRI scans, to assess the extent of the injury.
- Pre-Surgery Exercises: Strengthen your leg muscles through prescribed exercises to improve post-surgery recovery.
- Medications: Inform your doctor about any medications you are taking, as some may need to be adjusted or stopped before surgery.
- Stop Smoking and Alcohol: Avoid smoking and alcohol, as they can hinder healing and increase complications.
- Fasting: Follow fasting instructions (usually 6-8 hours) before surgery to ensure safety during anaesthesia.
- Home Preparation: Arrange for mobility aids like crutches and set up a comfortable recovery area at home.
- Transportation and Assistance: Plan for someone to drive you to and from the hospital and assist you during the initial recovery days.
- Mental Readiness: Stay informed and mentally prepared for the procedure and the recovery process ahead.
ACL Reconstruction Surgery Procedure
- Anesthesia Administration: General or regional anaesthesia is used to keep the patient comfortable and pain-free throughout surgery.
- Arthroscopic Examination: A small camera (arthroscope) is inserted through tiny incisions to inspect the knee joint and confirm the extent of damage.
- Removal of Torn ACL: The damaged ligament is carefully removed using surgical tools through additional small incisions.
- Graft Harvesting: A tendon graft, often from the patient’s hamstring or patellar tendon, is prepared to replace the torn ACL.
- Graft Placement: The graft is introduced into the knee and carefully positioned via small holes drilled into the thigh bone (femur) and shinbone (tibia).
- Fixation: The graft is held in place with screws or other fixing devices to ensure stability during the healing phase.
- Closure: Sutures or staples are used to close the small incisions, followed by a sterile dressing.
- Postoperative Stabilization: A knee brace or bandage is used to immobilize and protect the knee immediately after surgery.
- Monitoring and Recovery: The patient is moved to the recovery room for monitoring before being discharged with detailed post-surgery care instructions.
ACL Reconstruction Surgery Recovery time
Reconstruction surgery typically takes 6 to 9 months, depending on progress and adherence to rehabilitation.
- First two weeks: Use crutches and a brace to control pain, reduce swelling, and re-establish fundamental knee movement.
- Weeks 3-6: Start physical therapy to enhance range of motion, strength, and stability.
- 3 to 6 months: Gradually resume non-contact activities and sports-specific training.
- 6 to 9 months: Complete recovery for high-impact sports, depending on strength and knee stability tests.
- Strict devotion to physiotherapy and follow-ups leads to a smoother recovery.
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- Infection: Rare, but possible at the incision sites.
- Blood Clots: Can form in the legs, leading to swelling or pain.
- Knee Stiffness: Difficulty straightening the knee.
- Graft Failure: The graft may fail to heal properly or become loose.
- Nerve Damage: In rare cases, nerves can be injured.
- Swelling and Pain: Swelling may persist beyond the normal recovery period.
- Scar Tissue: Excessive scarring may limit knee movement.
Precautions After ACL Reconstruction Surgery
- Rest and Elevate: Rest your knee and keep it elevated to reduce swelling.
- Pain Management: Take prescribed pain medications as directed.
- Use Crutches and Brace: Use crutches to avoid putting weight on the knee and wear a knee brace for support.
- Avoid Stress on Knee: Don’t put too much weight on the operated leg during the first few weeks.
- Follow Physical Therapy: Do your exercises to regain strength and movement.
- Avoid Strenuous Activities: No running or intense exercises until cleared by your doctor.
- Watch for Infection: Keep an eye on any signs of infection, like redness or drainage.
- Healthy Diet: Eat well to support healing and tissue recovery.
- Gradual Return to Activities: Slowly increase activity levels as your doctor advises.
- Follow-Up Visits: Keep all doctor appointments to track progress.
