These patients should strongly consider surgery to stabilise the knee. Repeated instability or abnormal movement in the knee can cause ongoing damage leading to stretching of other structures around the knee , meniscal tears or arthritis in the long term. If you do not elect to have surgery it is strongly advised that you give up sports that involve pivoting, sidestepping or rotation.
The hamstring tendons are harvested through a small incision just below the knee and are fashioned into a new graft which takes the place of your old cruciate ligament. Tunnels holes are then drilled in the tibia and femur the two bones making up the knee joint and the graft is passed trough this tunnel. The graft is then fixed with various devices at each end to stabilise it and allow it to heal to the bone.
The fixation devices vary and are surgeon specific. This surgery is mainly done using an arthroscope using small incisions approximately 1cm each.
The inside of the knee is thoroughly visualised and any other problems such as meniscal tears or damage to the joint lining articular cartilage are treated at the same time. During surgery local anaesthetic is injected into the knee to reduce the amount of pain you will feel.
Pain relieving medication will be provided for you both in hospital and at home. There may be a drain in your knee which will be removed prior to discharge. You will have a dressing on your wound and a compressive wrap. You will be seen by a physiotherapist prior to discharge who will teach you how to use crutches and show you some simple exercises to do at home.
Your dressing should be left intact until your first postoperative visit. Your graft is strong enough to put all your weight on your operated leg. You can walk around but rest as much as possible for the first week and elevate your leg when sitting.
Most patients require crutches for a week or so. You may shower but not bath or swim prior to your review. It is normal to have blood under the dressing. If there is excessive ooze the dressings can be changed by someone experienced in wound care. If concerned please contact your surgeon. You will be followed up in the rooms about 10 days after your operation when the dressings will be removed and the wounds inspected.
The surgery and any other findings will be explained to you. If there is any redness, increased swelling or you have temperatures you should contact the rooms or the hospital where the surgery was performed so they can contact your surgeon. Time off work depends on your work requirements and is very variable. Office workers usually require 2 weeks off work and manual labourers 2 to 3 months or longer. Physiotherapy is an integral part of the treatment and is recommended to start as early as possible.
Preoperative physiotherapy is helpful to better prepare the knee for surgery. The early aim is to regain range of motion, reduce swelling and achieve full weight bearing.
The remaining rehabilitation will be supervised by a physiotherapist and will involve activities such as exercise bike riding, swimming, proprioceptive exercises and muscle strengthening. Cycling can begin at 4 weeks, jogging can generally begin at around 3 months.
The graft is strong enough to allow sport at around 6 months however other factors come into play such as confidence, fitness and adequate fitness and training. Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place.
As it heals, the bone tunnels fill in. This holds the new ligament in place. Why the Procedure is Performed. ACL reconstruction may be used for these knee problems: Knee that gives way or feels unstable during daily activities Knee pain Inability to return to sports or other activities When other ligaments are also injured When your meniscus is torn Before surgery, talk to your health care provider about the time and effort you will need to recover. The risks from any anesthesia are: Allergic reactions to medicines Breathing problems The risks from any surgery are: Bleeding Infection Other risks from this surgery may include: Blood clot in the leg Failure of the ligament to heal Failure of the surgery to relieve symptoms Injury to a nearby blood vessel Pain in the knee Stiffness of the knee or lost range of motion Weakness of the knee.
Before the Procedure. During the 2 weeks before your surgery: You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen Advil, Motrin , naproxen Naprosyn, Aleve , and other drugs.
Ask your provider which drugs you should still take on the day of your surgery. If you have diabetes , heart disease, or other medical conditions, your surgeon will ask you to see the provider who treats you for these conditions. Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
If you smoke, try to stop. Smoking can slow down wound and bone healing. Ask your providers for help if you need it. Always let your provider know about any cold, flu, fever, herpes breakout, or other illnesses you may have before your surgery. On the day of your surgery: You will often be asked not to drink or eat anything for 6 to 12 hours before the procedure. Take your drugs you have been told to take with a small sip of water.
You will be told when to arrive at the hospital. After the Procedure. Outlook Prognosis. Better surgical methods and rehabilitation have led to: Less pain and stiffness after surgery. Fewer complications with the surgery itself. Faster recovery time. Alternative Names. Patient Instructions. ACL reconstruction - discharge Getting your home ready - knee or hip surgery Surgical wound care - open.
Knee Injuries and Disorders Read more. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as soccer, football, basketball and volleyball. Ligaments are strong bands of tissue that attach one bone to another bone. During ACL reconstruction, the torn ligament is removed and replaced with a band of tissue that usually connects muscle to bone tendon.
The graft tendon is taken from another part of your knee or from a deceased donor. ACL reconstruction is an outpatient surgery that's performed by a doctor who specializes in surgical procedures of the bones and joints orthopedic surgeon. The anterior cruciate ligament ACL is one of the key ligaments that help stabilize your knee joint. The ACL connects your thighbone femur to your shinbone tibia. It's most commonly torn during sports that involve sudden stops and changes in direction — such as basketball, soccer, tennis and volleyball.
The ACL — one of two ligaments that crosses the middle of the knee — connects your thighbone to your shinbone and helps stabilize your knee joint. Most ACL injuries happen during sports and fitness activities that can put stress on the knee:. A course of physical therapy may successfully treat an ACL injury for people who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.
ACL reconstruction is a surgical procedure. And, as with any surgery, bleeding and infection at the surgical site are potential risks. Other risks associated with ACL reconstruction include:.
Before your surgery, you'll likely undergo several weeks of physical therapy. The goal before surgery is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles. People who go into surgery with a stiff, swollen knee may not regain full range of motion after surgery. ACL reconstruction is an outpatient procedure, so you'll be able to go home the same day. Arrange for someone to drive you home. Tell your surgeon about any medications or dietary supplements you take.
If you regularly take blood-thinning medications, your doctor may ask you to stop taking these types of drugs for at least a week before surgery to reduce your risk of bleeding. Follow your doctor's instructions about when to stop eating, drinking and taking any other medication the night before your surgery. General anesthesia is typically used during ACL reconstruction, so you'll be unconscious during the procedure. ACL reconstruction is usually done through small incisions — one to hold a thin, tube-like video camera and others to allow surgical instruments access to the joint space.
Your surgeon will remove your damaged ligament and replace it with a segment of tendon. This replacement tissue is called a graft and it comes from another part of your knee or a tendon from a deceased donor. Your surgeon will drill sockets or tunnels into your thighbone and shinbone to accurately position the graft, which is then secured to your bones with screws or other devices. The graft will serve as scaffolding on which new ligament tissue can grow.
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