ACL reconstruction is a surgical procedure focused on the anterior cruciate ligament (ACL). It is generally undertaken to reconstruct an ACL tear or injury. The surgery can be done by mini-open technique or arthroscopically. The procedure uses an autograft in the replacement of the ACL itself. This graft is taken from elsewhere in the knee of either the same or opposite leg of the patient, such as the patella (kneecap) tendon or the hamstring tendon, which are the two most common grafts used.
Why is the ACL important?
The ACL is among the group of ligaments which connect the shin bone and the thigh bone. The ACL runs through the knee’s centre, and crosses the posterior cruciate ligament (PCL) diagonally. Together with the PCL, the ACL provides an important function – controlling the knee as it moves forwards or backwards. The most important function of the ACL is controlling the stability of the knee rotationally as you twist and turn such as in sports like football, rugby, basketball and so on. It is not uncommon for ACL injuries to occur concurrently with another torn ligament or tissue in the knee joint.
Why might I need to undergo ACL reconstruction?
In general, a person is a candidate for an ACL reconstruction if their knee is not stable especially in rotation, ie if your knee keeps giving way when you change direction. ACL reconstruction offers the dual benefits of stabilizing the knee, while also preventing the knee cartilage’s condition from getting more injuries to it everytime the knee gives way. ACL reconstruction is especially common in sports players who have suffered a ligament tear while playing sports which involves rotation, twisting and sudden changes of direction which puts a lot of pressure on the ACL. These sports include football, basketball, rugby, netball, gymnastics.
What does the ACL reconstruction procedure involve?
The operation is done under general anaesthesia. Initially an arthroscopy is undertaken to inspect the knee joint and to deal with meniscal cartilage tears and to remove the torn ACL. Professor Jari then makes a mini-open incision through which the bone tunnels are drilled for the new ligament and through the same small incision, he will harvest the patella tendon graft. The autograft is then passed up through the tibial and femoral tunnels. Screws are used to ensure that the autograft is secured in place. ACL reconstruction usually takes one to one and a half hours to complete. After the operation the patient is transferred to the recovery room and from there back to the ward at which point Professor Jari’s accelerated ACL rehabilitation programme will commence. For more general details on the ACL reconstruction procedure, please see the NHS Choices website.
What are the risks involved with ACL reconstruction?
ACL reconstruction is generally considered very safe, but as with all surgical procedures, there are risks present. Common effects of ACL reconstruction include a feeling of numbness in the area of the scar and swelling which typically goes down after a few weeks.
Less common effects of ACL reconstruction include bleeding, infection, stiffness of the knee which requires revision surgery, and deep vein thrombosis. The risk of these occurrences is considered very low.
ACL reconstruction surgery recovery time
After having their torn or injured ACL reconstructed, ACL reconstruction patients are usually able to resume work after a few weeks. This will depend on the nature of the patient’s job, and their recovery progress. For jobs which require long periods of standing or lifting heavy objects, it can be several weeks after surgery before ACL patients are able to return to work. With Professor Jari’s rehab programme, it is aimed for the patient to initially regain symmetrical motion (which takes an average of 4-6 weeks) and then commence a gym based strengthening programme. Once leg strength is symmetrical, then the patient commences a sports specific rehab programme. It can take 6-12 months to get back to full contact sports such as football depending on the patient’s progress.
Will I need physiotherapy following an ACL reconstruction?
Physiotherapy can be an important part of the rehabilitation process following ACL reconstruction surgery to address an ACL injury. Physiotherapy typically commences immediately after the operation. You will benefit from the advice of a physiotherapist, who will advise you on the best type of rehabilitative exercises before you return home following the ACL surgery procedure.
Why should I choose The Knee Doc for my ACL reconstruction?
Professor Sanjiv Jari, ‘The Knee Doc’, is a highly experienced surgeon considered one of the UK’s leading experts in ACL reconstruction. Manchester based Prof Jari has helped a number of professional athletes return to fitness after an ACL tear or ACL injury, guiding them through a full consultation, the surgical procedure itself, and all stages of recovery. Do you have any questions on ACL reconstruction, or want to book a consultation about an ACL reconstruction? Speak to The Knee Doc today.
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The appropriate treatment for you depends on many factors and will have to be assessed by the specialist treating you. Price packages will be personalised to you and your needs. We also work with multiple hospitals to offer our patients a price match service. Please get in touch if you wish to book a consultation with Professor Jari, one of Manchester’s leading Knee Surgeon.