ACL is an operation designed to restore knee stability and strength following the ligament has been torn. The remains of the torn ligament must be separated and replaced with another ligament from your body or with tissue from a corpse. The knee is a pivot joint where the femur, or thighbone, meets the tibia, or shinbone. This crucial joint is held together by these four ligaments, which links the bones to one another:
- anterior cruciate ligament (ACL)
- medial collateral ligament (MCL)
- lateral collateral ligament (LCL)
- posterior cruciate ligament (PCL)
Your ACL runs crosswise between the tibia and femur and keeps the tibia from slipping in front of the femur. It also gives strength to the knee when it rotates from side to side.
Procedure for ACL Surgery
You will be prepped for the operation by changing into a hospital gown and having an intravenous (IV) line placed in your arm. The IV will permit the surgical team to administer medications, anesthesia, or sedatives. Once the sample tissue is chosen, it is either surgically detached from your body or prepared from a corpse. The tendon is then supplied with “bone plugs,” or anchor points, to graft the tendon into the knee. During operation, a small incision is made in the front of the knee from an arthroscope — a thin tube costume with a fiber-optic camera and surgical tools. It enables your surgeon to see inside your knee during the method. The surgeon will first take out your torn ACL and clean that portion. They will then drill small holes into your tibia and femur so the bone plugs can be attached with posts, screws, staples, or washers.
Following the attachment of the new ligament, the surgeon will test your knee’s range of motion and tension to ensure the graft is secure. Finally, the opening will be stitched, the wound dressed, and your knee will be stabilized with a brace. The length of the surgery will vary depending on the experience of the surgeon and if additional procedures are performed (such as meniscal repair), among other factors. Typically, you can go home the day of your surgery.
Because ACL reconstruction is a surgical method, it carries certain risks, including:
- bleeding and blood clots
- continuous knee pain
- transmission of disease if the graft comes from a dead body
- knee stiffness or weakness
- loss of range of motion
- improper recovery if the graft is rejected by your immune system
Young children with ACL tears run the chances of growth plate injuries. Growth plates enable the bones to grow and are located at the ends of bones in the arms and legs. Growth plate damages can result in shortened bones. Your doctor will estimate these risks when deciding if the operation should wait until your child is old and their growth plates have formed into solid bone.
ACL reconstructive surgery remains the gold standard for repairing this moderate knee damage. The AAOS reports—about 82% to 90% of ACL reconstruction surgeries yield excellent outcomes and full knee stability.
After ACL Surgery
Rehabilitation is the route to success of ACL reconstruction. Immediately following the surgery, you will be advised to take painkillers, keep your incision clean and dry, and rest. Icing your knee is vital as it helps alleviate pain and reduces swelling. You will most likely have a follow-up consultation with your surgeon within a few weeks of surgery.
Here’s what to expect following ACL surgery:
- some pain
- restricted activity for many months
- walking with crutches or cane for up to six weeks
- wearing a knee brace for at least a week
Athletes typically come back to their sports within six to 12 months.
Once the operation has been deemed successful, physical therapy exercise can start. The success of such surgery varies from person to person.
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