The anterior cruciate ligament, known as the ACL, is the main stabilizing ligament of the knee. Injury while participating in sports or physical activity can tear this ligament, causing your knee to “give” during activity. ACL reconstruction surgery is a procedure used to reconstruct the ligament using a piece of tendon taken from your knee or hamstring (autograft) or from a deceased donor (allograft).
ACL surgery is performed arthroscopically by inserting an arthroscope through a very small incision. This type of scope consists of a light and camera on a flexible, thin tube that allows the surgeon to view the inside of the knee on a monitor instead of requiring the surgeon to open the knee for visibility. The entire procedure is guided by the images on the screen. At this point, small instruments can be inserted through incisions to remove the damaged ligament and reconstruct the ACL.
ACL reconstruction surgery has many benefits for patients:
- Minimally invasive in comparison to traditional open surgery
- Stabilizes the knee so you can enjoy being active
- Relieves pain
- Restores range of motion
- Involves very little scarring
- Includes faster recovery time than with other surgical methods
- Helps prevent further meniscal injury
- Prevents early onset Osteoarthritis
ACL surgery is used to reconstruct a torn ACL and regain proper movement and stability of the knee. It is especially recommended for those who are young and active.
ACL reconstruction can relieve the symptoms associated with a torn ACL, including:
- Persistent knee pain
- Knee buckling or giving out during day to day activities, such as walking or getting in and out of your car
- Knee joint stiffness
- Reduced range of motion
In the two weeks prior to your ACL surgery, you might be asked to do the following in preparation for the procedure:
- Avoid certain medications and supplements. Specific medications, like Tylenol and Ibuprofen, can increase the risk of bleeding during and after the surgery. Other medicines and supplements, like birth control, can increase the chance of blood clots. Your physician may advise you to stop taking these medications for a certain period of time before your surgery.
- Consult with your physician. If you are taking any drugs or might have an illness, you should discuss this with your physician prior to surgery.
- Do not eat or drink 6 to 12 hours prior to surgery. Your physician will inform you of the exact time span you will need to fast before your ACL surgery.
- Arrange a ride home from the airport. At ARO, we take care of your transportation throughout your visit, including your transport to and from the airport. Our goal is to minimize the amount of things you have to think about during your stay with us, making this process as easy for you as possible.
You will be given preparation instructions ahead of the ACL reconstruction by our skilled physicians and surgeons. Be sure to follow the instructions to avoid having to postpone your surgery to a later date.
You will be administered general anesthesia intravenously before the surgery. A small incision will be made to insert the arthroscope. After the initial incision for the arthroscope, other small incisions will be made around the knee to insert the instruments used to perform the ACL reconstruction. The torn ligament will be removed first. If your own tissue is being used to create your new ACL, the surgeon will make a larger cut to remove the autograft.
Next, tunnels will be created in your bone to pass the new tissue through so it is in the same place as your original ACL. The new ligament will be attached to the bone with screws. Over time, as it heals, the tunnels in the bone will fill in, naturally holding your new ligament in place.
Your incisions will be closed with stitches, and the area will be covered with a sterile dressing. A drain might be placed in the knee before the wound is closed to prevent excess swelling.
You will be moved to a recovery room and monitored for a short period of time before being discharged the same day. You may wear a knee brace for one to four weeks after ACL surgery. Crutches will also be needed for the same length of time to avoid placing pressure on the knee, though you will be encouraged to move the knee right after surgery to prevent stiffness. Pain after ACL reconstruction is common and managed with pain medications.
Within a few days of returning home, you will begin physical therapy. This can last from four to six months and will help you regain strength and range of motion in your knee. ARO will work with your local physicians to ensure you are setup to begin physical therapy as soon as the stitches are removed. We will also follow-up with your physical therapist and primary care physician to track your progress and help answer any questions you may have.
Full recovery from ACL reconstruction surgery can take from six months to a year.