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ACL, or Anterior Cruciate Ligament, is an important tissue band within the knee joint. It provides stability and facilitates smooth body movement. However, ACL injury is not a rare issue. A damaged ACL can cause pain, instability, limited mobility, and osteoarthritis. This is where ACL reconstruction comes to the rescue. ACL reconstruction procedure is a surgical procedure. It replaces a damaged ACL with a graft. This can be taken from either the patient’s tissue or from a donor. It is one of the most common orthopaedic techniques performed worldwide. This procedure does not only restore the knee’s structural integrity but also helps resume an active and pain-free lifestyle.
Synopsis
Understanding ACL Injuries
ACL is integral to stability and controlled movement. However, it has a certain capacity to take the stress. When that level exceeds, it causes ACL injury. It can affect any age group.
Activities that require sudden stops, direction change, or direct impact are more prone to ACL injury. The severity of an ACL injury is not the same for everyone. It can range from sprains to partial and complete tears. Thus, understanding the seriousness of this injury is key to determining the treatment methods accordingly.
What Are the Indications for ACL Reconstruction?
There are specific circumstances that make an ACL reconstruction surgery crucial. They are as follows:
- Complete ACL Tear
- Persistent Knee Instability
- Lifestyle Issues
- Ligament Injuries
- Maintenance of proper Knee Function
- Chronic ACL Deficiency
An expert orthopaedic surgeon is the best judge to determine whether you need ACL reconstruction or not. They will thoroughly evaluate your health condition and lifestyle before recommending this intervention.
Preparing for ACL Reconstruction
- Adequate preparation is mandatory to ensure optimal outcomes from ACL reconstruction.
- At first, there will be a series of diagnostic tests to evaluate the injury condition. Usually, an MRI is done to assess the damage.
- Doctors will thoroughly evaluate your health condition, age, and activity to analyse the suitability of this process.
- You can communicate all your concerns with the doctor to make sure everything is aligned.
- There are various graft options available. The two primary categories are autografts and allografts. Autografts are the ones taken from the patient’s tissue, usually from the patellar tendon or hamstring. The other type is sourced from a suitable donor. Doctors consider several factors before finalising the type of graft.
- Your orthopaedic surgeon may suggest some pre-operative guidelines. It may include fasting, medication, lifestyle management, etc. Follow them properly to avoid future complications.
- Do not get stressed over the procedure. Try to stay as relaxed as possible. You can talk to your doctor for advice.
The ACL Reconstruction Procedure
Let us first discuss the steps involved in ACL reconstruction surgery.
- Anaesthesia;
- Selection of the suitable graft;
- The process is usually performed arthroscopically. It involves small incisions around the knee. The doctor inserts a tiny camera (arthroscope) and other specialised instruments. It ensures checking the joint condition in detail without extensive incisions;
- Next, they will meticulously remove the damaged ACL. It will prepare the knee for graft placement. During this step, doctors will address other associated injuries, too;
- The graft will then be threaded through bone tunnels created in the tibia and femur. It is done by mimicking the natural position of the original ACL. The surgeon will use fixation devices for accurate graft integration with the tissues;
- Finally, the surgeon will close the incisions with sutures or staples;
- The wounds will be dressed with sterile methods for healing.
Several methods can be used to reconstruct an anterior cruciate ligament (ACL). The most common ACL reconstruction method is to use a tendon from elsewhere in your body to replace the ACL. It is usually a strip of your patellar tendon. It runs from the bottom of the kneecap (patella) to the top of the shin bone (tibia) at the front of your knee.
Otherwise, your surgeon may use a part of your hamstring tendons. These run from the back of your knee on the inner side up to your thigh. This tendon is then attached to your femur-thigh bone and tibia leg bone by Arthroscopic Surgery. The patient can go home the next day of the surgery. It will be suggested by your surgeon, depending on your condition.
Recovery After ACL Reconstruction
Following ACL reconstruction, doctors closely monitor patients. Follow the stages explained below to ensure faster and better recovery.
- Right after the surgery, your doctor will monitor your situation closely in the recovery area. Your doctor may allow you to bear minimal weights on the surgical leg with the help of crutches.
- The patient undergoes ACL Rehab with knee physiotherapy and exercises. Initially, it focuses on reducing swelling, regaining motion range, and muscle strengthening. There are targeted exercises to promote joint mobility.
- You will eventually progress to weight-bearing, from partial to full. This transformation will depend on how fast you are recovering.
- Therapists will work with you to strengthen the quadriceps, hamstrings, and other muscles. This phase is key to preparing your knee for more dynamic movements.
- For sports personnel, these exercises will eventually specialise. It may include agility drills, plyometrics, and balance exercises. It will be customised as per the patient’s requirements.
- This recovery process also involves the prevention of future injuries and optimising knee stability. That is why enhancing neuromuscular control is vital. It will help seamlessly integrate the reconstruction with your bodily movements.
You may usually be able to walk normally within a month. For athletes, the exercises are more rigorous, and it may take around 6 months to return to their lifestyle. Even after full recovery, you must keep in touch with your doctor and go on regular check-ups to decrease the risk of complications.
Complications Related to ACL Reconstruction
Just like any other medical procedure, ACL reconstruction also possesses some risk factors. It includes the following:
- Improper integration of the graft;
- Postoperative infections;
- Persistent knee instability;
- Stiff joint;
- Limited motion ranges;
- Nerve or blood vessel damages;
- Formation of blood clots;
- Pain;
- Swelling;
- Reaction to anaesthesia;
Connecting with a highly experienced orthopaedic surgeon can decrease the risk of such complications. After the ACL reconstruction surgery, it is essential to have patience. Do not rush into resuming your regular activities. Routine physiotherapy and exercises are mandatory for fast recovery. Make sure that you follow all the instructions given by your healthcare professional to eliminate further complications.
Consult the top orthopaedic surgeon at Manipal Hospitals, Hebbal, Bangalore, to receive the best possible treatment.
FAQ's
It varies depending on individual conditions. It can take from weeks to months. Progressive rehabilitation is necessary for consistent recovery.
While prevention is not guaranteed, you can take some measures to decrease the risks. Certain muscle-strengthening exercises and training programmes can assist you.
There are a few risk factors associated with the procedure. It includes graft failure, infections, pain, stiff joints, reaction to anaesthesia, etc.
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