Neurology

Anterior cruciate ligament surgery (ACL)

Description

Reconstruction of Anterior cruciate ligament (ACL) is a surgical procedure to restore the stability and strength of the knee ligament that has been injured or torn. ACL is a tough band of tissue located between the femur and the tibia and is responsible for joining the upper leg bone with the lower leg bone. Any kind of injury or trauma can tear the remnants of the ligaments and create difficulty in walking along with severe pain as ACL allows the back and forth movement of the lower leg. With the help of ACL surgery, the stability and the functioning of the knee will be restored and the pain will be reduced.

The main reason for the injury of the ACL is landing incorrectly from a jump, twisting of leg while walking or running and changing directions suddenly. ACL normally tears while indulging in sports activities such as football, tennis, etc.

During the procedure

Reconstruction of the ACL can be performed by surgery, however, there are few measures that need to take before performing the operation. You will require to wait for a while for swelling to completely go away. You will have to try to move your leg muscles up and down as strongly as possible in order to see full range of movement of your knee. If you can’t do that, the chances of recovery will be difficult. Your physiotherapist will advise you to perform some low impact exercises to regain your knee strength and full range of movement.

Before starting the procedure, you will be placed under general anesthesia to put you to sleep during the entire procedure. The surgeon will then deeply examine your knee by making an incision in the front of the knee and insert a medical instrument called an arthroscope. This tool allows the doctor to see inside of the knee and perform the operation accurately. Once the torn ACL is found, the doctor will look for any other damage to the knee that needs to be repaired. The graft tissue will then be removed and replaced with healthy tissues, which either comes from your own body, known as an autograft or from a deceased donor, known as an allograft. In some cases, synthetic tissues are also used to replace the damaged knee tissues. The replacement is done by drilling small holes into the tibia and femur and the tissues are attached with posts, staples, screws or washers.

The opening will then be closed with stitches and the doctor will examine your knee’s stability and functionality.

Complications

Like with any other surgical procedures, ACL surgery also contains some complications, which are:

  • Blood clots

  • Bleeding

  • Infection

  • Transmission of disease

  • Increased pain in knee

  • Stiffness and weakness

  • Rejection by immune system

  • Loss of range of motion

Post operative care

Following the surgery, some pain and discomfort can be expected for a few weeks or even months. You will be restricted from several activities as you will need crutches to walk for up to six weeks. You will also need to wear knee brace in order to prevent it from any injury or pressure.

You need to join a rehabilitation therapy that will help you perform normal activities such as walking or sitting during the recovery.

Pain medications will be given to control increased pain after the surgery.

Keep your incision clean and dry and provide your knee the needed rest. Icing the knee can help relieve from pain and swelling.

Follow all the appointments with your physiotherapy for examination of your knee and speed up the recovery.