ACL Reconstruction

1 What is an ACL Reconstruction?

ACL reconstruction is surgery procedure to replace the Anterior Cruciate Ligament (ACL).

This ligament is one of the major ligaments in the knee.

ACL injuries are more common in sports that involve abrupt stops and changes in direction such as basketball, soccer, tennis, football, downhill skiing, volleyball, and gymnastics.

In an ACL reconstruction, the torn ligament is removed and replaced with a piece of tendon from a different part of your knee or from a deceased donor.

This surgery is an outpatient procedure that is performed throughs minute incisions around your knee joint.

An ACL reconstruction is performed by a doctor who specializes in surgical procedures of the bones and joints (orthopedic surgeon).

2 Reasons for Procedure

Ligaments are strong bands of tissue that connect the bones are the most common reasons to receive an ACL reconstruction procedure.

The ACL, one of two ligaments that cross in the middle of the knee, connect the thigh bone or femur to the chin bone or tibia and helps stabilize your knee.

Most ACL injuries occur during sports and fitness activities that can put stress on the knee:

  • Sudden slowing down and changing direction (cutting)
  • pivoting with your foot firmly planted
  • incorrect landing from a jump
  • sudden stop and receiving a blow to the knee

A course of physical therapy may be successful in treating an ACL injury for people who are relatively inactive, engage in moderate exercise, or play sports that put less stress on the knees.

ACL reconstruction is generally recommended if:

  • you are an athlete and would wish to continue in your sport
  • more than one ligament or cartilage in your knee is injured
  • you are young and active and the injury is causing your knee to buckle during everyday activities

3 Potential Risks

Because ACL is a surgical procedure, bleeding and infection at the surgical site are a potential risk.

Other risks with ACL reconstruction include:

  • knee pain,
  • stiffness or weakness,
  • poor healing of the graft
  • and failure to receive symptome relief.

4 Preparing for your Procedure

To prepare for the ACL reconstruction, you are likely to undergo several weeks of physical therapy before the actual surgery procedure.

The goal of surgery is to reduce the pain and swelling, reduce the full range of motion of your knee and strengthen the muscles.

People who go into surgery with a stiff, swollen knee often have poor healing and do not regain full range of motion after surgery.

ACL reconstruction is an outpatient procedure, so you will able to go home later the same day.

Remember to have another individual drive you there.

Food and medications

It is very important to share with your surgeon a list of any medications, herbal or dietary supplements that you take on a regular basis.

If  aspirin or other blood-thinning medications are also taken, your doctor may ask you to stop taking them for at least a week before surgery to reduce your risk of bleeding.

It is very important to follow your doctor's instructions about when to stop eating, drinking and taking any other form of medication prior to your surgery.

5 What to Expect

Read on to learn more about what to expect before, during, and after your ACL reconstruction procedure.

Usually, general anaesthesia is used during ACL reconstructions, so you will be unconscious during the entirety of the procedure.

ACL reconstruction is usually performed through small incisions, one holds a thin, tube-like video camera (arthroscope) and another allows surgical instruments access to the joint space.

During the procedure

In the process of ACL reconstruction, the surgeon removes the damaged ligament rather than repairing it. The  damaged ligament is the substituted with a segment of the tendon, tissue similar to a ligament that connects muscle to bone.

This substitute tissue is known as a graft. Your surgeon will use a piece of tendon from another part of your knee or from a deceased donor. He or she will drill sockets or tunnels into your thigh and shin bones to precisely position the graft, which is further secured to the bones with screws or other fixative devices.

The graft will serve as a scaffolding on which new ligament tissue can develop.

After the procedure

Once the anaesthesia wears off, you will be allowed to go home. However, before you go home, you will have to practice walking with crutches, and your surgeon may ask you to wear a knee brace or splint to help protect the graft.

Prior to leaving the hospital, you will receive instructions on when you can shower or bathe, when you can change the dressings on the wound and how you can manage post-surgery care.

To reduce swelling and pain immediately after surgery, practice the R.I.C.E. model of self-care at home:

  • Rest,
  • apply Ice every two hours for 20 minutes,
  • Compress the knee by wrapping an elastic bandage or compression wrap
  • and Elevate your knee propped up on pillows.

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