ACL Reconstruction Surgery: Procedure and Recovery

ACL Reconstruction Surgery – Anterior Cruciate Ligament (ACL) reconstruction surgery is a common orthopedic procedure performed to repair a torn or ruptured ACL in the knee.

The ACL is a critical ligament that helps stabilize the knee joint, and its injury can result in pain, instability, and limitations in daily activities.

Understanding the ACL

The ACL is one of the major ligaments in the knee and plays a vital role in maintaining the stability of the joints. It connects the femur (thighbone) to the tibia (shinbone) and is responsible for preventing excessive forward movement of the tibia relative to the femur.

Injuries to the ACL are common, often occurring during sports or physical activities that involve sudden stops, pivoting, or changes in direction.

Indications for ACL Reconstruction Surgery

ACL reconstruction surgery is typically recommended for individuals with a torn or ruptured ACL, especially when:

1. The ACL tear is causing significant instability in the knee.

2. The individual is an athlete or leads an active lifestyle and wants to return to high-demand activities.

3. Other structures in the knee like meniscus are also damaged and require surgical treatment.

4. Conservative, non-surgical treatments, such as physiotherapy, have not provided sufficient relief or stability.

ACL Reconstruction Surgery Procedure

ACL reconstruction surgery is performed by orthopedic surgeons and typically involves the following steps:

1. Preoperative Evaluation

Prior to the surgery, the orthopedic surgeon will conduct an in-depth evaluation of the knee of the patient, which may involve physical examinations, imaging studies like MRI, and a discussion of the patient’s medical record and activity level.

This assessment helps the orthopedic surgeon in Delhi plan the procedure and choose the most suitable graft material for reconstruction.

2. Anesthesia

The surgery is executed under general or regional anesthesia, which means the patient is either fully not conscious or their lower body is desensitized. The choice of giving anesthesia relies on the health of the patient, his/her preferences, and the advice of the surgeon.

3. Graft Selection

The torn ACL is replaced with a graft, which serves as a scaffold for new ligament tissue to grow. The option of graft rests on certain factors, that may include the age of the patient, their activity levels, and the preference of the surgeon.

4. Arthroscopy

The surgeon makes small cuts around the knee and puts in a device called an arthroscope, i.e a thin layer of tube with a camera, to envision the structures of the joints. This minimally invasive approach allows the surgeon to assess the extent of damage and perform the procedure with smaller incisions.

5. ACL Removal

The damaged ACL is removed from the knee joint to make room for the new graft.

6. Graft Preparation

The chosen graft is prepared for insertion. The surgeon may trim and shape the graft to match the length and diameter of the original ACL.

7. Graft Insertion

The surgeon drills tunnels into the tibia and femur, precisely replicating the attachment points of the original ACL. The graft is then interweaved via these tunnels and shielded in place using equipment such as screws, staples, or other fixation devices. The graft acts as a scaffold for the body to generate new ligament tissue.

8. Closure and Dressing

The surgeon closes the incisions with sutures and covers them with sterile dressings. Sometimes, a brace or a compression bandage may be applied to stabilize the knee.

The entire procedure typically takes a few hours, and patients are usually discharged on the same day. But due to the circumstances and case of an individual, few of them may be required to stay more in the hospital.

ACL Reconstruction Surgery Recovery

The recovery process after ACL reconstruction surgery is a critical phase, and it plays a significant role in determining the long-term success of the procedure. It involves several stages and requires commitment to rehabilitation and follow-up care.

1. Early Postoperative Period (1-7 days)

• Pain Management: Pain, aches and malaise are quite common after surgery. Pain medication schedule as advised by the surgeon will help in managing this.

• Immobilization: A knee brace may be used to limit movement initially. The use of crutches is common to avoid putting weight on the surgical leg.

• Ice and Elevation: Putting on ice and elevating the leg can help in lowering down your level of swelling.

• Physical Therapy: Rehabilitation typically begins within the first week. Gentle exercises are introduced to prevent stiffness and muscle atrophy. Range of motion exercises are crucial during this phase.

2. Intermediate Postoperative Period (2-6 weeks)

• Weight-Bearing: The gradual transition to partial weight-bearing is introduced. The patient may continue to use crutches but with increasing weight on the surgical leg.

• Physical Therapy: Exercises become more challenging and focus on strengthening the leg muscles and improving joint flexibility.

• Scar Care: The care of surgical incisions is necessary to stop infections from happening and promote the optimal amount of healing.

3. Late Postoperative Period (2-6 months)

• Full Weight-Bearing: By this stage, the patient should be able to bear full weight on the surgical leg and discontinue the use of crutches.

• Advanced Physical Therapy: Rehabilitation continues with a focus on functional strength, balance, and proprioception. Patients work to regain their range of motion, stability, and functional movement.

4. Return to Sport and Normal Activities (6 months and beyond)

• Gradual Return to Sports: Athletes can gradually reintroduce sports-specific activities. The timing varies from person to person and is determined by the surgeon’s and physical therapist’s guidance.

• Long-Term Follow-Up: Consistent follow-up visits on a regular basis with your surgeon is quite essential to keep a check on your progress and ensure the stability and the functionality of the knees.

Conclusion:

However, it’s essential to understand that the success of the surgery depends on the patient’s commitment to postoperative care and rehabilitation.

With the guidance of healthcare professionals, proper physical therapy, and a gradual return to activities, many individuals can regain their knee’s strength and function and return to their desired level of activity.

Ultimately, ACL reconstruction surgery can provide patients with the opportunity for an active life post-injury.